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Document and Entity Information - shares	9 Months Ended
Document and Entity Information - shares	Sep. 30, 2018	Nov. 01, 2018
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2018
Document Fiscal Year Focus	2018
Document Fiscal Period Focus	Q3
Trading Symbol	MDRX
Entity Registrant Name	ALLSCRIPTS HEALTHCARE SOLUTIONS, INC.
Entity Central Index Key	0001124804
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		174,714,207

CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 111,775	$ 155,839
Restricted cash	8,016	6,659
Accounts receivable, net of allowance of $61,926 and $37,735 as of September 30, 2018 and December 31, 2017, respectively	520,381	567,873
Contract assets	71,745	0
Prepaid expenses and other current assets	131,826	115,463
Total current assets	843,743	845,834
Fixed assets, net	160,225	165,603
Software development costs, net	239,359	222,189
Intangible assets, net	873,635	826,872
Goodwill	2,207,967	2,004,953
Deferred taxes, net	5,566	4,574
Contract assets - long-term	52,555	0
Other assets	135,030	148,849
Long-term assets attributable to discontinued operations	0	11,276
Total assets	4,518,080	4,230,150
Current liabilities:
Accounts payable	126,709	97,583
Accrued expenses	120,326	85,915
Accrued compensation and benefits	107,799	99,632
Deferred revenue	506,568	546,830
Current maturities of long-term debt	19,516	27,687
Current maturities of non-recourse long-term debt - Netsmart	4,257	2,755
Current maturities of capital lease obligations	9,190	7,865
Total current liabilities	894,365	868,267
Long-term debt	1,002,026	906,725
Non-recourse long-term debt - Netsmart	788,489	625,193
Long-term capital lease obligations	4,606	7,105
Deferred revenue	21,804	24,047
Deferred taxes, net	124,294	93,643
Other liabilities	95,575	92,205
Liabilities attributable to discontinued operations	2,261	21,358
Total liabilities	2,933,420	2,638,543
Redeemable convertible non-controlling interest - Netsmart	467,981	431,535
Commitments and contingencies
Stockholders’ equity:
Preferred stock: $0.01 par value, 1,000 shares authorized, no shares issued and outstanding as of September 30, 2018 and December 31, 2017	0	0
Common stock: $0.01 par value, 349,000 shares authorized as of September 30, 2018 and December 31, 2017; 270,506 and 174,707 shares issued and outstanding as of September 30, 2018, respectively; 269,335 and 180,832 shares issued and outstanding as of December 31, 2017, respectively	2,708	2,693
Treasury stock: at cost, 96,099 and 88,504 shares as of September 30, 2018 and December 31, 2017, respectively	423,521	322,735
Additional paid-in capital	1,765,103	1,781,059
Accumulated deficit	(251,363)	(338,150)
Accumulated other comprehensive loss	(5,452)	(1,985)
Total Allscripts Healthcare Solutions, Inc.'s stockholders' equity	1,087,475	1,120,882
Non-controlling interest	29,204	39,190
Total stockholders’ equity	1,116,679	1,160,072
Total liabilities and stockholders’ equity	$ 4,518,080	$ 4,230,150

CONSOLIDATED BALANCE SHEETS (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Statement Of Financial Position [Abstract]
Accounts receivable, allowance	$ 61,926	$ 37,735
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock, shares authorized	1,000,000	1,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	349,000,000	349,000,000
Common stock, shares issued	270,506,000	269,335,000
Common stock, shares outstanding	174,707,000	180,832,000
Treasury stock at cost, shares	96,099,000	88,504,000

CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Revenue:
Revenue from contract with customers	$ 522,279,000	$ 449,442,000	$ 1,561,782,000	$ 1,289,008,000
Cost of revenue:
Amortization of software development and acquisition-related assets	34,557,000	28,001,000	101,008,000	81,788,000
Total cost of revenue	303,908,000	247,523,000	909,773,000	720,946,000
Gross profit	218,371,000	201,919,000	652,009,000	568,062,000
Selling, general and administrative expenses	133,214,000	117,352,000	425,365,000	340,234,000
Research and development	69,747,000	51,057,000	220,066,000	146,748,000
Asset impairment charges	0	0	30,075,000	0
Amortization of intangible and acquisition-related assets	13,000,000	8,137,000	37,210,000	23,340,000
Income (loss) from operations	2,410,000	25,373,000	(60,707,000)	57,740,000
Interest expense	(29,343,000)	(22,252,000)	(80,843,000)	(62,722,000)
Other loss, net	(525,000)	(570,000)	(590,000)	(545,000)
Gain on sale of businesses, net	0	0	172,258,000	0
Impairment of long-term investments	0	(20,700,000)	(15,487,000)	(165,290,000)
Equity in net (loss) income of unconsolidated investments	(177,000)	449,000	529,000	706,000
(Loss) income from continuing operations before income taxes	(27,635,000)	(17,700,000)	15,160,000	(170,111,000)
Income tax benefit	3,789,000	238,000	3,020,000	1,073,000
(Loss) income from continuing operations, net of tax	(23,846,000)	(17,462,000)	18,180,000	(169,038,000)
Income from discontinued operations, net of tax	0	0	3,731,000	0
Net (loss) income	(23,846,000)	(17,462,000)	21,911,000	(169,038,000)
Less: Net loss (income) attributable to non-controlling interests	4,000	(163,000)	3,494,000	(352,000)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart	(12,149,000)	(10,962,000)	(36,446,000)	(32,887,000)
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ (35,991,000)	$ (28,587,000)	$ (11,041,000)	$ (202,277,000)
Basic
Continuing operations	$ (0.20)	$ (0.16)	$ (0.09)	$ (1.12)
Discontinued operations	0.00	0.00	0.03	0.00
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	(0.20)	(0.16)	(0.06)	(1.12)
Diluted
Continuing operations	(0.20)	(0.16)	(0.09)	(1.12)
Discontinued operations	0.00	0.00	0.03	0.00
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$ (0.20)	$ (0.16)	$ (0.06)	$ (1.12)
Software delivery, Support and Maintenance [Member]
Revenue:
Revenue from contract with customers	$ 330,397,000	$ 289,102,000	$ 996,569,000	$ 832,323,000
Cost of revenue:
Total cost of revenue	109,682,000	86,893,000	328,534,000	259,361,000
Client services [Member]
Revenue:
Revenue from contract with customers	191,882,000	160,340,000	565,213,000	456,685,000
Cost of revenue:
Total cost of revenue	$ 159,669,000	$ 132,629,000	$ 480,231,000	$ 379,797,000

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Statement Of Income And Comprehensive Income [Abstract]
Net (loss) income	$ (23,846)	$ (17,462)	$ 21,911	$ (169,038)
Other comprehensive (loss) income:
Foreign currency translation adjustments	(60)	693	(1,622)	3,040
Change in unrealized (loss) gain on available for sale securities	0	(4)	0	56,507
Change in fair value of derivatives qualifying as cash flow hedges	(1,602)	(692)	(2,695)	341
Other comprehensive (loss) income before income tax benefit (expense)	(1,662)	(3)	(4,317)	59,888
Income tax benefit (expense) related to items in other comprehensive income (loss)	416	271	850	(126)
Total other comprehensive (loss) income	(1,246)	268	(3,467)	59,762
Comprehensive (loss) income	(25,092)	(17,194)	18,444	(109,276)
Less: Comprehensive loss (income) attributable to non-controlling interests	4	(163)	3,494	(352)
Comprehensive (loss) income, net	$ (25,088)	$ (17,357)	$ 21,938	$ (109,628)

CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($)	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Cash flows from operating activities:
Net income (loss)	$ 21,911,000	$ (169,038,000)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization	200,829,000	155,108,000
Stock-based compensation expense	29,810,000	28,140,000
Excess tax benefits from stock-based compensation	0	0
Write-off of unamortized deferred debt issuance costs - Netsmart	855,000	0
Deferred taxes	(5,347,000)	(5,324,000)
Asset impairment charges	30,075,000	0
Impairment of long-term investments	15,487,000	165,290,000
Equity in net income of unconsolidated investments	(529,000)	(706,000)
Gain on sale of businesses, net	(172,258,000)	0
Other (losses) income, net	(101,000)	3,711,000
Changes in operating assets and liabilities (net of businesses acquired):
Accounts receivable and contract assets, net	8,051,000	(31,256,000)
Prepaid expenses and other assets	(8,901,000)	(6,939,000)
Accounts payable	19,111,000	2,908,000
Accrued expenses	8,817,000	(6,196,000)
Accrued compensation and benefits	(4,873,000)	5,930,000
Deferred revenue	(59,595,000)	18,661,000
Other liabilities	(1,788,000)	12,894,000
Net cash provided by operating activities	81,554,000	173,183,000
Cash flows from investing activities:
Capital expenditures	(26,670,000)	(40,216,000)
Capitalized software	(101,272,000)	(107,079,000)
Cash paid for business acquisitions, net of cash acquired	(343,873,000)	(54,308,000)
Cash received from sale of businesses, net	241,153,000	0
Purchases of equity securities, other investments and related intangible assets	(2,723,000)	(5,423,000)
Other proceeds from investing activities	64,000	215,000
Net cash used in investing activities	(233,321,000)	(206,811,000)
Cash flows from financing activities:
Proceeds from sale or issuance of common stock	1,283,000	0
Taxes paid related to net share settlement of equity awards	(8,763,000)	(6,777,000)
Payments of capital lease obligations	(8,071,000)	(9,013,000)
Credit facility payments	(260,478,000)	(115,281,000)
Credit facility borrowings, net of issuance costs	497,493,000	189,698,000
Repurchase of common stock	(101,905,000)	(12,077,000)
Payment of acquisition financing obligations	(3,226,000)	(2,398,000)
(Purchases) sales of subsidiary shares owned by non-controlling interest	(6,945,000)	1,494,000
Net cash provided by financing activities	109,388,000	45,646,000
Effect of exchange rate changes on cash and cash equivalents	(328,000)	796,000
Net (decrease) increase in cash and cash equivalents	(42,707,000)	12,814,000
Cash, cash equivalents and restricted cash, beginning of period	162,498,000	96,610,000
Cash, cash equivalents and restricted cash, end of period	$ 119,791,000	$ 109,424,000

Basis of Presentation and Significant Accounting Policies	9 Months Ended
	Sep. 30, 2018
Accounting Policies [Abstract]
Basis of Presentation and Significant Accounting Policies	1. Basis of Presentation and Significant Accounting Policies Principles of Consolidation The consolidated financial statements include the accounts of Allscripts Healthcare Solutions, Inc. (“Allscripts”) and its wholly-owned subsidiaries and controlled affiliates. All significant intercompany balances and transactions have been eliminated. Each of the terms “we,” “us,” “our” or the “Company” as used herein refers collectively to Allscripts Healthcare Solutions, Inc. and its wholly-owned subsidiaries and controlled affiliates, unless otherwise stated. Unaudited Interim Financial Information The unaudited interim consolidated financial statements as of and for the three and nine months ended September 30, 2018 and 2017 have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission (the “SEC”) for interim financial reporting. These interim consolidated financial statements are unaudited and, in the opinion of our management, include all adjustments, consisting of normal recurring adjustments and accruals, necessary to present fairly the consolidated financial statements for the periods presented in accordance with generally accepted accounting principles in the United States of America (“GAAP”). The consolidated results of operations for the three and nine months ended September 30, 2018 are not necessarily indicative of the results to be expected for the full year ending December 31, 2018. Certain information and footnote disclosures normally included in annual financial statements prepared in accordance with GAAP have been condensed or omitted in accordance with the SEC's rules and regulations for interim reporting. The Company believes that the disclosures made are adequate to make that information not misleading. These unaudited interim consolidated financial statements should be read in conjunction with the consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 2017 (our “Form 10-K”). Use of Estimates The preparation of consolidated financial statements in accordance with GAAP requires us to make estimates and assumptions that affect the amounts reported and disclosed in the consolidated financial statements and the accompanying notes. Actual results could differ materially from these estimates. Change in Presentation During the first quarter of 2018, we changed the presentation of certain bundled revenue streams. Such revenue was previously included as part of software delivery, support and maintenance revenue. Under the new presentation, such revenue is included as part of client services revenue. The revenues previously reported for the three and nine months ended September 30, 2017 have been recast to match the new presentation by reducing software delivery, support and maintenance and increasing client services by $5.1 million and $13.6 million, respectively. Significant Accounting Policies We adopted Financial Accounting Standards Board (“FASB”) Accounting Standards Update No. 2014-09, Revenue from Contracts with Customers: Topic 606 (“ASC 606”) effective on January 1, 2018 using the modified retrospective method for all contracts not completed as of the date of adoption. There have been no other significant changes to our significant accounting policies from those disclosed in our Form 10-K. Recently Adopted Accounting Pronouncements In January 2016, the FASB issued Accounting Standards Update No. 2016-01, “Recognition and Measurement of Financial Assets and Financial Liabilities” (“ASU 2016-01”). The amendments in ASU 2016-01 modify the requirements related to the measurement of certain financial instruments in the statement of financial condition and results of operation. Equity investments (except those accounted for under the equity method of accounting or those that result in consolidation of the investee) are required to be measured at fair value with changes in fair value recognized in net income. An entity may continue to elect to measure equity investments which do not have a readily determinable fair value at cost with adjustments for impairment, if any, and observable changes in price. In addition, for a liability (other than a derivative liability) that an entity measures at fair value, any change in fair value related to the instrument-specific credit risk (i.e., the entity’s own credit risk), should be presented separately in other comprehensive income and not as a component of net income. ASU 2016-01 also clarifies that an entity should evaluate the need for a valuation allowance on a deferred tax asset related to available-for sale securities in combination with the entity’s other deferred tax assets. We adopted ASU 2016-01 effective January 1, 2018 and there was no immediate impact upon adoption. Refer to Note 4, “Fair Value Measurements and Long-term Investments,” for additional information regarding our unconsolidated equity investments. In January 2017, the FASB issued Accounting Standards Update No. 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business (“ASU 2017-01”). ASU 2017-01 provides new accounting guidance to assist an entity in evaluating when a set of transferred assets and activities is a business. We adopted ASU 2017-01 effective January 1, 2018 and there was no immediate impact upon adoption. Accounting Pronouncements Not Yet Adopted In August 2018, the FASB issued Accounting Standards Update No. 2018-15, “Intangibles - Goodwill and Other - Internal-Use Software (Subtopic 350-40)” (“ASU 2018-15”), which discusses customer accounting for implementation costs incurred in a cloud computing arrangement that is a service contract. ASU 2018-15 requires an entity (customer) in a hosting arrangement that is a service contract to follow the guidance in Subtopic 350-40 to determine which implementation costs to capitalize as an asset related to the service contract and which costs to expense. Training costs and certain data conversion costs that cannot be capitalized under Subtopic 350-40 also cannot be capitalized for a hosting arrangement that is a service contract. Costs for implementation activities in the application development state are capitalized depending on the nature of the costs, while costs incurred during preliminary stages are expensed. ASU 2018-15 requires the entity to expense the capitalized implementation costs of a hosting arrangement that is a service contract over the term of the hosting arrangement and apply existing impairment guidance in Subtopic 350-40 to the capitalized implementation costs related to each module or component of a hosting arrangement that is a service contract. ASU 2018-15 also requires the entity to present the expense related to the capitalized implementation costs in the same line item in the statement of operations as the fees associated with the hosting element of the arrangement and classify payments for capitalized implementation costs in the statement of cash flows in the same manner as payments made for fees associated with the hosting element. The entity is required to present the capitalized implementation costs in the balance sheet in the same line item that a prepayment for the hosting arrangement fees would be presented. ASU 2018-15 is effective for interim and annual periods beginning after December 15, 2019. Early adoption is permitted and can be applied either retrospectively or prospectively. We early adopted ASU 2018-15 on a prospective basis effective October 1, 2018 and do not expect any impact upon adoption. In August 2018, the FASB issued Accounting Standards Update No. 2018-13, “Fair Value Measurement (Topic 820) – Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement” (“ASU 2018-13”), which eliminates, adds and modifies certain disclosure requirements for fair value measurements. Entities will no longer be required to disclose the amount of and reasons for transfers between Level 1 and Level 2 of the fair value hierarchy, but public companies will be required to disclose the range and weighted average used to develop significant unobservable inputs for Level 3 fair value instruments. ASU 2018-13 will be effective for all entities for interim and annual periods beginning after December 15, 2019, with early adoption permitted. We are currently evaluating the impact of this accounting guidance. In June 2018, the FASB issued Accounting Standards Update No. 2018-07, “Compensation-Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting” (“ASU 2018-07”), which expands the scope of Topic 718 to include share-based payment transactions for acquiring goods and services from nonemployees. ASU 2018-07 specifies that Topic 718 applies to all share-based payment transactions in which a grantor acquires goods or services to be used or consumed in its own operations by issuing share-based payment awards. ASU 2018-07 also clarifies that Topic 718 does not apply to share-based payments used to effectively provide (1) financing to the issuer or (2) awards granted in conjunction with selling goods or services to customers as part of a contract accounted for under ASC 606. ASU 2018-07 is effective for interim and annual periods beginning after December 15, 2018. We are currently evaluating the impact of this accounting guidance. In February 2016, the FASB issued Accounting Standards Update No. 2016-02, “Leases (Topic 842)” (“ASU 2016-02”), intended to improve financial reporting about leasing transactions. The new guidance will require entities that lease assets to recognize on their balance sheets the assets and liabilities for the rights and obligations created by those leases and to disclose key information about the leasing arrangements. ASU 2016-02 is effective for interim and annual periods beginning after December 15, 2018 with early adoption permitted. We plan to adopt ASU 2016-02 on January 1, 2019 using the cumulative-effect adjustment transition method approved by the FASB in July 2018. We are in the process of implementing changes to our processes and internal controls to meet the new reporting and disclosure requirements. We have implemented a software tool to assist us in the calculation of the amount of additional assets and liabilities to be included on our consolidated balance sheet related to leases currently classified as operating leases with durations greater than twelve months. In addition to existing lease agreements, we are also reviewing service contracts and other agreements to determine if they contain an embedded lease. We continue to evaluate the expected impact of ASU 2016-02 on disclosures, but do not anticipate any material changes to operating results or liquidity as a result of right-of-use assets and corresponding lease liabilities that will be recorded. In January 2017, the FASB issued Accounting Standards Update No. 2017-04, Intangibles—Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment (“ASU 2017-04”), which provides new accounting guidance to simplify the accounting for goodwill impairment. ASU 2017-04 removes Step Two of the goodwill impairment test, which requires a hypothetical purchase price allocation. Under the new guidance, a goodwill impairment will equal the amount by which a reporting unit’s carrying value exceeds its fair value, not to exceed the carrying amount of goodwill assigned to the reporting unit. All other goodwill impairment guidance will remain largely unchanged. Entities will continue to have the option to perform a qualitative assessment to determine if a quantitative impairment test is necessary. ASU 2017-04 is effective for annual and interim periods in fiscal years beginning after December 15, 2019 with early adoption permitted for any goodwill impairment tests performed after January 1, 2017. The new guidance is to be applied prospectively. We are currently evaluating the impact of this accounting guidance, including the timing of adoption. In August 2017, the FASB issued Accounting Standards Update No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities (“ASU 2017-12”), which provides new accounting guidance to simplify and improve the reporting of hedging relationships to better portray the economic results of an entity’s risk management activities in its financial statements. In addition to that main objective, the amendments in ASU 2017-12 make certain targeted improvements to simplify the application of the hedge accounting guidance in current GAAP. ASU 2017-12 is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years, with early adoption permitted. We will adopt ASU 2017-02 on January 1, 2019. We do not believe that any other recently issued, but not yet effective accounting standards, if adopted, would have a material impact on our consolidated financial statements.

Revenue from Contracts with Customers

9 Months Ended

Sep. 30, 2018

Revenue From Contract With Customer [Abstract]

Revenue from Contracts with Customers

2. Revenue from Contracts with Customers

Our two primary revenue streams are (i) software delivery, support and maintenance and (ii) client services. Software delivery, support and maintenance revenue consists of all of our proprietary software sales (either under a perpetual or term license delivery model), subscription-based software sales, transaction-related revenue, the resale of hardware and third-party software and revenue from post-contract client support and maintenance services, which include telephone support services, maintaining and upgrading software and ongoing enhanced maintenance. Client services revenue consists of revenue from managed services solutions, such as private cloud hosting, outsourcing and revenue cycle management, as well as other client services and project-based revenue from implementation, training and consulting services. For some clients, we host the software applications licensed from us using our own or third-party servers. For other clients, we offer an outsourced service in which we assume partial to total responsibility for a healthcare organization’s IT operations using our employees.

Adoption of New Revenue Standard (“ASC 606”)

In May 2014, the FASB issued ASC 606 to supersede nearly all existing revenue recognition guidance under GAAP. The core principle of ASC 606 is to recognize revenue when promised goods or services are transferred to customers in an amount that reflects the consideration that is expected to be received for those goods or services. ASC 606 defines a five-step process to achieve this principle and, in doing so, it is possible more judgment and estimates may be required within the revenue recognition process than required under the previous FASB Accounting Standards Codification 605, Revenue Recognition (“ASC 605”), including identifying performance obligations in the contract, estimating the amount of variable consideration to include in the transaction price and allocating the transaction price to each separate performance obligation and accounting for significant financing components. Additionally, ASC 606 provides guidance related to costs of obtaining a contract with a customer that an entity expects to recover.

The new revenue recognition guidance permits two methods of adoption: retrospectively to each prior reporting period presented (full retrospective method), or retrospectively with the cumulative effect of initially applying the guidance recognized at the date of initial application (modified retrospective method). We adopted the standard effective on January 1, 2018 using the modified retrospective method. We also implemented internal controls, and continue to refine our updated processes and key systems to allow us to continue to comply with the new requirements.

The reported results for the three and nine months ended September 30, 2018 reflect the adoption of ASC 606. The comparative information for the three and nine months ended September 30, 2017 has not been restated and will continue to be reported under the previous guidance of ASC 605, which was in effect during that period. The table below reflects the cumulative adjustments that were made to balances previously reported in the condensed consolidated balance sheet as of December 31, 2017. During the nine months ended September 30, 2018, we identified additional cumulative adjustments, which resulted in a decrease to Accumulated deficit of $14.8 million, an increase to Accounts receivable, net of $0.6 million, an increase to Contract assets of $13.9 million, an increase to Deferred taxes, net of $5.2 million and a decrease to Deferred revenue, current of $5.5 million.

	As Reported			Adjustments			Adjusted
(In thousands)	December 31, 2017			due to ASC 606			January 1, 2018
Accounts receivable, net	$	567,873		$	(31,948	)	$	535,925
Contract assets		0			90,449			90,449
Prepaid expenses and other current assets		115,463			11,646			127,109

Deferred revenue, current		546,830			(12,901	)		533,929
Deferred revenue, long-term		24,047			0			24,047
Deferred taxes, net		93,643			21,668			115,311
Accumulated deficit		(338,150	)		61,380			(276,770	)

The adoption of ASC 606 had no impact on cash from or used in operating, financing or investing activities reported in our consolidated statement of cash flows for the year ended December 31, 2017. The following tables compare the reported condensed consolidated balance sheet and statement of operations as of and for the three and nine months ended September 30, 2018 to the pro-forma amounts assuming the previous guidance of ASC 605 had been in effect:

	September 30, 2018
(In thousands)	As reported under ASC 606			Adjustments due to ASC 606			Pro forma under ASC 605
Accounts receivable, net	$	520,381		$	52,523		$	572,904
Contract assets		71,745			(71,745	)		0
Prepaid expenses and other current assets		131,826			(13,184	)		118,642
Contract assets - long-term		52,555			(52,555	)		0

Deferred revenue, current		506,568			21,522			528,090
Deferred taxes, net		124,294			(27,816	)		96,478
Accumulated deficit		(251,363	)		(78,667	)		(330,030	)

	Three Months Ended September 30, 2018
(In thousands, except per share amounts)	As reported under ASC 606			Adjustments due to ASC 606			Pro forma under ASC 605
Software delivery, support and maintenance	$	330,397		$	(4,351	)	$	326,046
Client services		191,882			(5,516	)		186,366
Gross profit		218,371			(9,119	)		209,252
Selling, general and administrative expenses		133,214			247			133,461
Income (loss) from operations		2,410			(9,366	)		(6,956	)
Loss from continuing operations before income taxes		(27,635	)		(9,598	)		(37,233	)
Income tax benefit		3,789			2,522			6,311
Net loss		(23,846	)		(7,076	)		(30,922	)
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(35,991	)	$	(7,076	)	$	(43,067	)
Loss per share - basic attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(0.20	)	$	(0.04	)	$	(0.24	)
Loss per share - diluted attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(0.20	)	$	(0.04	)	$	(0.24	)

	Nine Months Ended September 30, 2018
(In thousands, except per share amounts)	As reported under ASC 606			Adjustments due to ASC 606			Pro forma under ASC 605
Software delivery, support and maintenance	$	996,569		$	(15,486	)	$	981,083
Client services		565,213			(7,469	)		557,744
Gross profit		652,009			(22,539	)		629,470
Selling, general and administrative expenses		425,365			140			425,505
Loss from operations		(60,707	)		(22,679	)		(83,386	)
Income (loss) from continuing operations before income taxes		15,160			(23,435	)		(8,275	)
Income tax (provision) benefit		3,020			6,148			9,168
Net income		21,911			(17,287	)		4,624
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(11,041	)	$	(17,287	)	$	(28,328	)
Loss per share - basic attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(0.06	)	$	(0.10	)	$	(0.16	)
Loss per share - diluted attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(0.06	)	$	(0.10	)	$	(0.16	)

The recognition of revenue related to hardware sales, software-as-a-service-based offerings, client services, electronic data interchange services and managed services remained substantially unchanged under ASC 606. The adoption of ASC 606 resulted in an increase in contract assets driven by upfront recognition of revenue, rather than over the subscription period, from certain multi-year software subscription contracts that include both software licenses and software support and maintenance.

Costs to Obtain or Fulfill a Contract

Under ASC 605, we only capitalized direct sales commissions that were specifically associated with new or renewal contracts. The new revenue recognition guidance under ASC 606 requires the capitalization of all incremental costs of obtaining a contract with a customer that an entity expects to recover. As part of our implementation efforts, we identified certain indirect commissions and other payments that were eligible for capitalization under ASC 606 as they were incremental costs solely associated with new or renewal contracts that we expected to recover. Certain costs related to the fulfillment of contracts are also capitalized. As a result, we recorded a deferral for such costs of $8.6 million, net of tax, upon adoption of the new guidance on January 1, 2018, which was included in the cumulative effect of initially applying ASC 606.

Capitalized costs to obtain or fulfill a contract are amortized over periods ranging from two to nine years which represent the initial contract term or a longer period, if renewals are expected and the renewal commission, if any, is not commensurate with the initial commission. We classify such capitalized costs as current or non-current based on the expected timing of expense recognition. The current and non-current portions are included in Prepaid expenses and other current assets, and Other assets, respectively, in our consolidated balance sheets.

At September 30, 2018, we had capitalized costs to obtain or fulfill a contract of $26.6 million in Prepaid and other current assets and $34.2 million in Other assets. During the three months ended September 30, 2018, we recognized $7.5 million of amortization expense related to such capitalized costs, of which $7.4 million is included in selling, general and administrative expenses and $0.1 million is included in cost of revenue in our consolidated statements of operations. During the nine months ended September 30, 2018, we recognized $23.3 million of amortization expense related to such capitalized costs, of which $22.9 million is included in selling, general and administrative expenses and $0.4 million is included in cost of revenue in our consolidated statement of operations.

Contract Balances

The timing of revenue recognition, billings and cash collections results in billed and unbilled accounts receivables, contract assets and customer advances and deposits. Accounts receivable, net includes both billed and unbilled amounts where the right to receive payment is unconditional and only subject to the passage of time. Contract assets include amounts where revenue recognized exceeds the amount billed to the customer and the right to payment is not solely subject to the passage of time. Deferred revenue includes advanced payments and billings in excess of revenue recognized. Our contract assets and deferred revenue are reported in a net position on an individual contract basis at the end of each reporting period. Contract assets are classified as current or long-term based on the timing of when we expect to complete the related performance obligations and bill the customer. Deferred revenue is classified as current or long-term based on the timing of when we expect to recognize revenue.

In general, with the exception of fixed fee project-based client service offerings (such as implementation services), we sell our software solutions on date-based milestone events where control transfers and use of the software occurs on the delivery date but the associated payments for the software license occur on future milestone dates. In such instances, unbilled amounts are included in contract assets since our right to receive payment is conditional upon the continued functionality of the software and the provision of ongoing support and maintenance. Our fixed fee project-based client service offerings typically require us to provide the services with either a significant portion or all amounts due prior to service completion. Since our right to payment is not unconditional, amounts associated with work prior to the completion date are also deemed to be contract assets.

Performance Obligations

A performance obligation is a promise in a contract to transfer a distinct product or service to a customer and is the unit of account in ASC 606. A performance obligation is considered distinct when both (i) a customer can benefit from the product or service either on its own or together with other resources that are readily available to the customer and (ii) the promised product or service is separately identifiable from other promises in the contract. Activities related to the fulfillment of a contract that do not transfer products or services to a customer, such as contract preparation or legal review of contract terms, are not deemed to be performance obligations. Based on the similarities in the definitions of a “deliverable” under ASC 605 and “performance obligation” under ASC 606, our identification of performance obligations under ASC 606 did not result in a significant divergence from our existing identification approach.

We generally sell our solutions through multi-element arrangements where we provide the customer with (1) software license, (2) support and maintenance, (3) embedded content such as third-party software and (4) client services. Incremental solutions, such as hardware and managed services are also provided based upon a customer’s preferences and requirements. We deem that a customer is typically able to benefit from a product or service on its own or together with readily available resources when we sell such product or service on a standalone basis. We have historically sold the majority of our performance obligations, with the exception of software licenses, on a standalone basis. Incremental solutions, such as hardware, client services and managed services, are often negotiated and fulfilled on an independent sales order basis as customer needs and requirements change over the course of a relationship period. In addition, support and maintenance and embedded content are provided on a stand-alone basis through the renewal process.

One of the product offerings under our CareInMotion^TM platform requires significant client service customization to enable the functionality of the software before the customer can obtain benefit from using the product. The significant customization cannot be performed by a third party. Software products and client services are separately identifiable in these contracts, but the performance obligations are not considered distinct in the context of the contract. Therefore, these products and services are treated as a combined performance obligation.

Additionally, our support and maintenance obligations include multiple discrete performance obligations, with the two largest being unspecified product upgrades or enhancements, and technical support, which can be offered at various points during a contract period. We believe that the multiple discrete performance obligations within our overall support and maintenance obligations can be viewed as a single performance obligation since both the unspecified product upgrades and technical support are activities to fulfill the maintenance performance obligation and are rendered concurrently.

The breakdown of revenue recognized related based on the origination of performance obligations and elected accounting expedients is presented in the table below:

(In thousands)	Three Months Ended March 31, 2018		Three Months Ended June 30, 2018		Three Months Ended September 30, 2018
Revenue related to deferred revenue balance at beginning of period	$	204,297	$	215,519	$	177,692
Revenue related to new performance obligations satisfied during the period		257,222		244,082		290,145
Revenue recognized under "right-to-invoice" expedient		49,638		62,812		51,587
Reimbursed travel expenses, shipping and other revenue		2,769		3,164		2,855
Total revenue	$	513,926	$	525,577	$	522,279

The aggregate amount of contract transaction price related to remaining unsatisfied performance obligations (commonly referred to as “backlog”) represents contracted revenue that has not yet been recognized and includes both deferred revenue and amounts that will be invoiced and recognized as revenue in future periods. Total backlog equaled $4.7 billion as of September 30, 2018, of which we expect to recognize approximately 39% over the next 12 months, and the remaining 61% thereafter.

Transaction price and allocation

Our contracts with customers often include multiple distinct performance obligations such as software licenses, software support and maintenance, hardware, client services, private cloud hosting and Software-as-a-Service. We adjust the transaction price on a contract-by-contract basis for (i) the effect of the time value of money when a contract has a significant financing component and/or (ii) customer discounts and incentives deemed to be variable consideration. We then allocate the contract transaction price to the distinct performance obligations in the contract. Such allocation is based on the stand-alone selling price (“SSP”) of each distinct performance obligation. The transaction price allocated to each distinct performance obligation is adjusted for discounts offered to customers that are outside of the Company’s established sufficiently narrow ranges for distinct performance obligations’ SSPs on a relative SSP basis.

For each distinct performance obligation, we use observable stand-alone pricing to determine the SSP. Such observable SSPs are based upon our listed sales prices and consider discounts offered to customers. In instances where SSP is not directly observable because we do not sell the product or service separately, we determine the SSP through the residual approach or cost-plus margin models using information that includes market conditions and other observable inputs. Such instances primarily relate to sales of new products and service offerings and our acute suite of software licenses. Our acute suite of software licenses is sold to a diverse set of customers for a broad range of amounts and, therefore, SSP is not discernible from past transactions due to the high variability of selling prices.

Our products and services are generally not sold with a right of return, except for certain hardware sales, which are not material to our consolidated revenue. We may provide credits or incentives on a contract-by-contract basis which are accounted for either as a material right or as variable consideration, respectively, when allocating the transaction price. Such credits and incentives have historically not been significant. We do not provide additional warranties to clients above and beyond warranties that the solutions purchased will perform in accordance with the agreed-upon specifications. On rare occasions, when additional warranties are granted, we evaluate on a case-by-case basis whether the additional warranty granted represents a separate performance obligation.

The majority of our contracts contain provisions that require customer payment no later than one year from the transfer of control of the related performance obligation. Some of our contracts contain a significant financing component resulting in a time value of money adjustment when the distinct performance obligation, such as software licenses, is delivered at a point in time, but the customer payments are over an extended future period that can range from 2 to 10 years. The time value of money adjustment is excluded from the transaction price at contract inception and is recognized over the respective future payment term as interest income. The discount rate used is determined at the time of contract inception and is based on investment grade bond rates with duration equal to the expected payment term. Interest income recognized totaled $0.2 million and $0.7 million during the three and nine months ended September 30, 2018, respectively.

Accounting Policy Elections and Practical Expedients

We have elected to exclude from the measurement of the transaction price all taxes (e.g., sales, use, value-added) assessed by government authorities and collected from a customer. Therefore, revenue is recognized net of such taxes.

Within the normal course of business, we contract with customers to deliver and ship tangible products, such as computer hardware. In these situations, the control of the products transfers to the customer when the product reaches the shipper based on free on board (FOB) shipping clauses. We have elected to use the practical expedient allowed under ASC 606 to account for shipping and handling activities that occur after the customer has obtained control of a promised good as fulfillment costs rather than as an additional promised service and, therefore, we do not allocate a portion of the transaction price to a shipping service obligation. Instead, we record as revenue any amounts billed to customers for shipping and handling costs and record as cost of revenue the actual shipping costs incurred.

Additionally, our standard contract terms allow for the reimbursement by a customer for certain travel expenses necessary to provide on-site services to the customer, such as implementation and training. Such reimbursed travel expenses are reported on a gross basis. Since such reimbursed travel expenses do not represent a distinct good or service nor incremental value provided to a customer, a performance obligation is deemed not to exist. In certain situations, however, when the allowable reimbursable expenses amount is capped, we believe that such cap represents the most likely amount of variable consideration and the capped amount is included in the total contract transaction price.

In accordance with ASC 606, if an entity has a right to consideration from a customer in an amount that corresponds directly with the value to the customer of the entity’s performance completed to date, the entity may recognize revenue in the amount to which the entity has a right to invoice (“right-to-invoice” practical expedient). We have elected to utilize this expedient as it relates to transaction-based services (such as revenue cycle management) and electronic data interchange transactions.

Revenue Recognition

We recognize revenue only when we satisfy an identified performance obligation (or bundle of obligations) by transferring control of a promised product or service to a customer. We consider a product or service to be transferred when a customer obtains control because a customer has sole possession of the right to use (or the right to direct the use of) the product or service for the remainder of its economic life or to consume the product or service in its own operations. We evaluate the transfer of control primarily from the customer’s perspective as this reduces the risk that revenue is recognized for activities that do not transfer control to the customer.

The majority of our revenue is recognized over time because a customer continuously and simultaneously receives and consumes the benefits of our performance. The exceptions to this pattern are our sales of perpetual and term software licenses, and hardware, where we determined that a customer obtains control of the asset upon granting of access, delivery or shipment. The following table summarizes the pattern of revenue recognition for our most significant performance obligations:

Performance Obligation	Revenue Type	Recurring or Non-recurring Nature	Revenue Recognition Pattern	Measure of progress
Support and maintenance ("SMA")	Software delivery, support and maintenance	Recurring	Over time	Output method (time elapsed) – revenue is recognized ratably over the contract term
Software as a service ("SaaS")	Software delivery, support and maintenance	Recurring	Over time	Output method (time elapsed) – revenue is recognized ratably over the contract term
Private cloud hosting	Client services	Recurring	Over time	Output method (time elapsed) – revenue is recognized ratably over the contract term
Client/Education services	Client services	Non-recurring	Over time	Input method (cost to cost) – revenue is recognized proportionally over the service implementation based on hours
Outsourcing services	Client services	Recurring	Over time	Input method (cost to cost) – revenue is recognized proportionally over the outsourcing period
Payerpath (transaction volume)	Software delivery, support and maintenance	Recurring	Over time	Output method ("right-to-invoice" practical expedient) – value transferred to the customer is reflected on invoicing.
Software licenses	Software delivery, support and maintenance	Non-recurring	Point in time	Upon electronic delivery
Hardware	Software delivery, support and maintenance	Non-recurring	Point in time	Upon shipment

Recurring software delivery, support and maintenance revenue consists of recurring subscription-based software sales, support and maintenance revenue, and recurring transaction-related revenue. Non-recurring software delivery, support and maintenance revenue consists of perpetual software licenses sales, resale of hardware and non-recurring transaction-related revenue. Recurring client services revenue consists of revenue from managed services solutions, such as outsourcing, private cloud hosting and revenue cycle management. Non-recurring client services revenue consists of project-based client services revenue.

When evaluating our SMA, SaaS and private cloud hosting performance obligations, we noted that these obligations are fulfilled as stand-ready obligations to perform and, therefore, we deem the obligations to be satisfied evenly over time. Client services, such as those relating to implementation, consulting, training or education, are generally not fulfilled evenly over the contract period but rather over a shorter timeline where work effort can rise or decline based upon stages of the project work effort. These client services are typically quoted to a customer as a fixed fee amount that covers the implementation effort. Delivery progress for these services is measured by establishing an approved cost budget with labor hour inputs utilized to gauge percentage of completion of the work effort. Therefore, revenue for our client, education and outsourcing services is recognized proportionally with the progress of the implementation work effort.

Payerpath transaction volume and other transaction-based service obligations, such as revenue cycle management services, are fulfilled over time but are not provided evenly over the contract period and reliable inputs are not available to track progress of completion. We determined that value is provided to the customer throughout the contract period and the pricing charged to the customer varies on a monthly basis, based upon the volume of the customer’s transactions processed in that respective period. The invoiced amount to the customer represents this value and, accordingly, the practical expedient to recognize revenue based upon invoicing is most appropriate.

We considered the specific implementation guidance for accounting for licenses of intellectual property (“IP”) to determine if point in time or over time recognition was more appropriate. The first step in the licensing framework is to determine whether the license is distinct or combined with other goods and services. For most of our software licensing products, the licenses are distinct, with the exception of one of our product offerings under our CareInMotion^TM platform, which requires a significant client service customization. In all instances, we determined that we are offering functional IP as compared with a symbolic IP. Functional IP is a right to use IP because the IP has standalone functionality and a customer can use the IP as it exists at a point in time.

Disaggregation of Revenue

We disaggregate our revenue from contracts with customers based on the type of revenue and nature of revenue stream, as we believe those categories best depict how the nature, amount, timing and uncertainty of our revenue and cash flows are affected by economic factors. The below tables summarize revenue by type and nature of revenue stream as well as by our reportable segments:

	Three Months Ended September 30,				Nine Months Ended September 30,
(In thousands)	2018		2017		2018		2017
Revenue:
Software delivery, support and maintenance
Recurring revenue	$	285,564	$	230,577	$	873,010	$	682,107
Non-recurring revenue		44,833		58,525		123,559		150,216
Total software delivery, support and maintenance		330,397		289,102		996,569		832,323
Client services
Recurring revenue	$	136,015	$	109,285	$	392,874	$	314,567
Non-recurring revenue		55,867		51,055		172,339		142,118
Total client services		191,882		160,340		565,213		456,685
Total revenue	$	522,279	$	449,442	$	1,561,782	$	1,289,008

	Three Months Ended September 30, 2018
(In thousands)	Clinical and Financial Solutions		Population Health		Netsmart		Unallocated			Discontinued Operations		Total
Software delivery, support and maintenance	$	225,259	$	51,613	$	56,283	$	(2,758	)	$	0	$	330,397
Client services		156,202		8,065		35,799		(8,184	)		0		191,882
Total revenue	$	381,461	$	59,678	$	92,082	$	(10,942	)	$	0	$	522,279

	Three Months Ended September 30, 2017
(In thousands)	Clinical and Financial Solutions		Population Health		Netsmart		Unallocated			Discontinued Operations		Total
Software delivery, support and maintenance	$	192,351	$	40,896	$	52,588	$	3,267		$	0	$	289,102
Client services		127,145		3,627		31,030		(1,462	)		0		160,340
Total revenue	$	319,496	$	44,523	$	83,618	$	1,805		$	0	$	449,442

	Nine Months Ended September 30, 2018
(In thousands)	Clinical and Financial Solutions		Population Health		Netsmart		Unallocated			Discontinued Operations			Total
Software delivery, support and maintenance	$	691,084	$	163,708	$	157,479	$	(3,666	)	$	(12,036	)	$	996,569
Client services		453,853		22,743		103,455		(17,029	)		2,191			565,213
Total revenue	$	1,144,937	$	186,451	$	260,934	$	(20,695	)	$	(9,845	)	$	1,561,782

	Nine Months Ended September 30, 2017
(In thousands)	Clinical and Financial Solutions		Population Health		Netsmart		Unallocated			Discontinued Operations		Total
Software delivery, support and maintenance	$	553,493	$	119,606	$	148,633	$	10,591		$	0	$	832,323
Client services		366,294		10,854		86,413		(6,876	)		0		456,685
Total revenue	$	919,787	$	130,460	$	235,046	$	3,715		$	0	$	1,289,008

Business Combinations

9 Months Ended

Sep. 30, 2018

Business Combinations [Abstract]

Business Combinations

3. Business Combinations

2018 Business Combinations

Acquisition of Health Grid

On May 18, 2018, we acquired all the capital stock of Health Grid Holding Company, a Delaware corporation (“Health Grid”), for a total price of $110.0 million, consisting of an initial payment of $60.0 million plus up to an aggregate of $50.0 million in future earnout payments based on Health Grid achieving certain revenue targets over the three years following the acquisition (subject to adjustments for net working capital, cash, debt and transaction expenses). At the time of closing, we pre-paid $10.0 million of the earnout payments and the remaining contingent consideration of up to $40.0 million was valued at $23.9 million. Health Grid is a patient engagement solutions provider that assists independent providers, hospitals and health systems to improve patient interactions and satisfaction. We plan to integrate the capabilities of Health Grid into our FollowMyHealth^® platform. The consideration paid for Health Grid is shown below:

	(In thousands)
Aggregate purchase price	$	60,000
First earnout payment paid by Allscripts		10,000
Fair value of contingent consideration payment		23,915
Closing purchase price adjustments		2,009
Total consideration paid for Health Grid	$	95,924

The allocation of the fair value of the consideration transferred as of the acquisition date of May 18, 2018 is shown in the table below. This allocation is preliminary as working capital balances are subject to changes. The goodwill is not expected to be deductible for tax purposes.

	(In thousands)
Cash and cash equivalents	$	1,783
Accounts receivable, net		3,968
Prepaid expenses and other assets		185
Fixed assets		200
Intangible assets		41,000
Goodwill		53,953
Accounts payable and accrued expenses		(478	)
Deferred revenue		(700	)
Long-term deferred tax liability		(3,987	)
Net assets acquired	$	95,924

The following table summarizes the preliminary fair values of the identifiable intangible assets and their estimated useful lives:

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Customer Relationships	15	$	28,000
Technology	8		13,000
		$	41,000

We incurred $0.2 million and $0.5 million of acquisition costs which are included in selling, general and administrative expenses in the accompanying consolidated statement of operations for the three and nine months ended September 30, 2018, respectively. The results of operations of Health Grid were not material to our consolidated results of operations for the three and nine months ended September 30, 2018.

Acquisition of Practice Fusion, Inc.

On February 13, 2018, we completed the acquisition of Practice Fusion, Inc., a Delaware corporation (“Practice Fusion”), for aggregate consideration of $113.6 million paid in cash. Practice Fusion offers an affordable certified cloud-based electronic health record (“EHR”) for traditionally hard-to-reach small, independent physician practices. The consideration paid for Practice Fusion is shown below:

	(In thousands)
Aggregate purchase price	$	100,000
Add: Net working capital surplus		373
Add: Closing cash		14,951
Less: Adjustment to assumed indebtedness		(1,684	)
Total consideration paid for Practice Fusion	$	113,640

The allocation of the fair value of the consideration transferred as of the acquisition date of February 13, 2018 is shown in the table below. The allocation of the purchase price was finalized during the third quarter of 2018. The goodwill is not expected to be deductible for tax purposes.

	(In thousands)
Cash and cash equivalents	$	14,951
Accounts receivable, net		13,328
Prepaid expenses and other current assets		809
Fixed assets		1,764
Intangible assets		67,200
Goodwill		35,234
Other assets		42
Accounts payable and accrued expenses		(7,620	)
Deferred revenue		(2,400	)
Long-term deferred tax liability		(8,853	)
Other liabilities		(815	)
Net assets acquired	$	113,640

The following table summarizes the fair values of the identifiable intangible assets and their estimated useful lives:

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Customer Relationships - Physician Practices	15	$	28,700
Customer Relationships - Pharmaceutical Partners	20		19,800
Technology	8		14,800
Tradenames	10		3,900
		$	67,200

We incurred $0.0 million and $0.8 million of acquisition costs which are included in selling, general and administrative expenses in the consolidated statement of operations for the three and nine months ended September 30, 2018, respectively. The results of operations of Practice Fusion were not material to our consolidated results of operations for the three and nine months ended September 30, 2018.

Acquisition of Barista Operations, LLC

On July 2, 2018, ECS Acquisition Co. LLC, a Delaware limited liability company and a wholly-owned subsidiary of Netsmart (the “Purchaser”), purchased from Change Healthcare Technologies, LLC, a Delaware limited liability company (“CHT”), and Change Healthcare Holdings, LLC, a Delaware limited liability company (“CHC” and, together with CHT, the “Sellers”), all issued and outstanding membership interests of Barista Operations, LLC, a Delaware limited liability company (“Barista”). Barista owns and operates the extended care solutions business of Sellers and their subsidiaries providing information technology solutions and services to the Care at Home industry, which comprises the Extended Care Solutions business of McKesson Technology Solutions that was contributed to CHC by McKesson Corporation effective March 1, 2017. The purchase price for the acquisition was $167.5 million and was funded through borrowings under the Netsmart Credit Agreements. The purchase price is subject to adjustments for net working capital. Additionally, $2.5 million of the purchase price was deposited into escrow at the closing of the acquisition and is subject to release to the Sellers or to the Purchaser based on the achievement of certain revenue thresholds.

In accordance with the purchase agreement, (i) CHC will provide certain transition services to Purchaser pursuant to a transition services agreement and (ii) CHC and Netsmart Technologies will negotiate in good faith and use commercially reasonable efforts to enter into certain commercial arrangements pursuant to which, among other things, Netsmart Technologies will market and sell certain products of CHC.

The allocation of the fair value of the consideration transferred as of the acquisition date of July 2, 2018 is shown in the table below. This allocation is preliminary as balances are subject to changes. The goodwill is deductible for tax purposes and will be amortized over 15 years for tax purposes.

	(In thousands)
Accounts receivable, net	$	4,470
Contract assets		800
Prepaid expenses and other assets		407
Fixed assets		2,842
Intangible assets		64,000
Goodwill		99,938
Other assets		281
Accounts payable		(1,005	)
Accrued expenses		(764	)
Deferred revenue		(5,838	)
Other liabilities		(300	)
Net assets acquired	$	164,831

The following table summarizes the fair values of the identifiable intangible assets and their estimated useful lives:

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Customer Relationships	16	$	55,500
Technology	5		8,500
		$	64,000

Other Acquisitions and Divestiture

On June 15, 2018, we acquired all the outstanding minority interest in a third party for $6.9 million. We initially acquired a controlling interest in the third party in April 2015. Therefore, this transaction was treated as an equity transaction and the cash payment is reported as part of cash flow from financing activities in the consolidated statement of cash flows for the nine months ended September 30, 2018.

On April 2, 2018, Allscripts Healthcare, LLC, a wholly-owned subsidiary of the Company (“Healthcare LLC”), and certain subsidiaries of Healthcare LLC and Hyland Software, Inc., an Ohio corporation (“Hyland”), completed the transactions contemplated by an Asset Purchase Agreement (the “Asset Purchase Agreement”) by which Hyland acquired substantially all of the assets of the Allscripts’ business providing hospitals and health systems document and other content management software and services generally known as “OneContent.” Allscripts acquired the OneContent business during the fourth quarter of 2017 through the acquisition of the EIS Business (as defined below). Certain assets of Allscripts relating to the OneContent business were excluded from the transaction and retained by Allscripts, as described in the Asset Purchase Agreement. In addition, Hyland assumed certain liabilities related to the OneContent business under the terms of the Asset Purchase Agreement. The total consideration for the OneContent business was $260 million, which was subject to certain adjustments for liabilities assumed by Hyland and net working capital as described in the Asset Purchase Agreement. We realized a gain upon sale of $177.9 million which is included in the “Gain on sales of businesses, net” line in our consolidated statements of operations for the nine months ended September 30, 2018.

On March 15, 2018, we entered into an agreement with a third party to contribute certain assets and liabilities of our Strategic Sourcing business unit, acquired as part of the acquisition of the EIS Business in 2017, into a new entity. We were also obligated to contribute $2.7 million of cash as additional consideration, which was paid in April 2018. In exchange for our contributions, we obtained a 35.7% interest in the new entity, which was valued at $4.0 million, and is included in Other assets in our consolidated balance sheet as of September 30, 2018. This investment is accounted for under the equity method of accounting. As a result of this transaction, we recognized an initial loss of $0.9 million and $4.7 million in additional losses due to measurement period adjustments upon the finalization of carve-out balances, mainly related to accounts receivable. These losses are included on the “Gain on sale of businesses, net” line in our consolidated statements of operations for the nine months ended September 30, 2018.

On February 6, 2018, we acquired all of the common stock of a cloud-based analytics software platform provider for a purchase price of $8.0 million in cash. The allocation of the consideration is as follows: $3.7 million of intangible assets related to technology; $0.6 million to customer relationships; $4.8 million of goodwill; $0.8 million to accounts receivable; accounts payable of $0.2 million; deferred revenue of $0.6 million and $1.1 million of long-term deferred income tax liabilities. The allocation was finalized in the third quarter of 2018. The acquired intangible asset related to technology will be amortized over 8 years using a method that approximates the pattern of economic benefits to be gained from the intangible asset. The customer relationship will be amortized over one year. The goodwill is not expected to be deductible for tax purposes. The results of operations of this acquisition were not material to our consolidated results of operations for the three and nine months ended September 30, 2018.

On January 31, 2018, Netsmart entered into a Unit Purchase Agreement with a third-party provider of billing solutions, for aggregate consideration of $5.4 million, plus net working capital consideration relative to a predetermined target, to acquire 100% of the equity of the entity. This transaction has been accounted for as a business combination. Of the total consideration, $2.0 million was paid in cash at closing with the remaining $3.6 million to be paid evenly on the first and second anniversaries of closing. This transaction resulted in the preliminary recognition of goodwill of $2.5 million. The purchase accounting for this transaction has not yet been completed. The results of operations of this acquisition were not material to our consolidated results of operations for the three and nine months ended September 30, 2018.

Pre-2018 Business Combination Updates

Acquisition of DeVero

On July 17, 2017, Netsmart completed the acquisition of DeVero, Inc. (“DeVero”), a healthcare technology company that develops electronic medical record solutions for home healthcare and hospice, for an aggregate purchase price of $50.5 million in cash. The allocation of the purchase price was finalized during the first quarter of 2018.

Acquisition of the Patient/Provider Engagement Solutions Business from NantHealth, Inc.

On August 25, 2017, the Company completed the acquisition of substantially all of the assets relating to the provider/patient engagement solutions business of NantHealth, Inc. (“NantHealth”). During the nine months ended September 30, 2018, measurement period adjustments to the purchase price allocation were recorded which resulted in an increase in goodwill of $0.1 million. The allocation of the purchase price was finalized during the third quarter of 2018.

Acquisition of the Enterprise Information Solutions Business from McKesson Corporation

On October 2, 2017, Healthcare LLC completed the acquisition of McKesson Corporation’s Enterprise Information Solutions Business division (the “EIS Business”), which provides certain software solutions and services to hospitals and health systems, by acquiring all of the outstanding equity interests of two indirect, wholly-owned subsidiaries of McKesson Corporation. The acquisition of the EIS Business was based on a total enterprise value of $185.0 million. During the nine months ended September 30, 2018, we recorded measurement period adjustments to the purchase price allocation which resulted in an increase in goodwill of $39.6 million, primarily resulting from an increase in deferred revenue of $44.0 million, a decrease in working capital of $1.8 million, and an increase in tax liabilities of $0.4 million, partially offset by increases in identified intangible assets of $6.6 million. At September 30, 2018 the purchase price allocation remains subject to further adjustment, primarily with respect to certain acquired intangible assets and deferred revenue.

Formation of Joint Business Entity and Acquisition of Netsmart, Inc.

On March 20, 2016, we entered into a Contribution and Investment Agreement with GI Netsmart Holdings LLC, a Delaware limited liability company (“GI Partners”), to form a joint business entity to which we contributed our Homecare^TM business and GI Partners made a cash contribution. On April 19, 2016, the joint business entity acquired Netsmart, Inc., a Delaware corporation. As a result of these transactions (the “Netsmart Transaction”), the joint business entity combined the Allscripts Homecare^TM business with Netsmart, Inc. Throughout this Form 10-Q, the joint business entity is referred to as “Netsmart”. As part of the Netsmart Transaction, we deposited $15 million in an escrow account to be used by Netsmart to facilitate the integration of our Homecare^TM business within Netsmart over five years, at which time the restriction on any unused funds will lapse. As of September 30, 2018, there is $7.0 million remaining in the escrow account.

Supplemental Information

The supplemental pro forma results below were calculated after applying our accounting policies and adjusting the results of the EIS Business and NantHealth to reflect (i) the additional amortization that would have been charged resulting from the fair value adjustments to intangible assets, (ii) the additional interest expense associated with Allscripts’ borrowings under its revolving facility, and (iii) the additional amortization of the estimated adjustment to decrease the assumed deferred revenue obligations to fair value that would have been recorded assuming both acquisitions occurred on January 1, 2016, together with the consequential tax effects.

The revenue and earnings of the EIS Business, since October 2, 2017, and NantHealth, since August 25, 2017, are included in our consolidated statement of operations. NantHealth revenue and net loss since the date of acquisition included in consolidated statement of operations for the three and nine months ended September 30, 2017 was $0.6 million and $0.6 million, respectively. The below supplemental pro forma revenue and net loss of the combined entity is presented as if both acquisitions had occurred on January 1, 2016.

(In thousands, except per share amounts)	Three Months Ended September 30, 2017			Nine Months Ended September 30, 2017
Supplemental pro forma data for combined entity:
Revenue	$	551,497		$	1,596,570
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	14,713		$	(195,899	)
Loss per share, basic and diluted	$	(0.08	)	$	(1.08	)

Fair Value Measurements and Long-term Investments

9 Months Ended

Sep. 30, 2018

Fair Value Disclosures [Abstract]

Fair Value Measurements and Long-term Investments

4. Fair Value Measurements and Long-term Investments

Fair value measurements are based upon observable and unobservable inputs. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect our view of market participant assumptions in the absence of observable market information. We utilize valuation techniques that maximize the use of observable inputs and minimize the use of unobservable inputs. The fair values of assets and liabilities required to be measured at fair value are categorized based upon the level of judgment associated with the inputs used to measure their value in one of the following three categories:

Level 1: Inputs are unadjusted quoted prices in active markets for identical assets or liabilities at the measurement date. We held no Level 1 financial instruments at September 30, 2018 or December 31, 2017.

Level 2: Inputs, other than quoted prices included in Level 1, are observable for the asset or liability, either directly or indirectly. Our Level 2 derivative financial instruments include foreign currency forward contracts valued based upon observable values of spot and forward foreign currency exchange rates. Refer to Note 10, “Derivative Financial Instruments,” for further information regarding these derivative financial instruments.

Level 3: Unobservable inputs are significant to the fair value of the asset or liability, and include situations where there is little, if any, market activity for the asset or liability. Our Level 3 financial instruments include derivative financial instruments comprising the 1.25% Call Option asset and the 1.25% embedded cash conversion option liability that are not actively traded. These derivative instruments were designed with the intent that changes in their fair values would substantially offset, with limited net impact to our earnings. The sensitivity of changes in the unobservable inputs to the valuation pricing model used to value these instruments is not material to our consolidated results of operations. Refer to Note 10, “Derivative Financial Instruments,” for further information regarding these derivative financial instruments. Our Level 3 financial liabilities also include the estimated fair value of contingent consideration related to completed acquisitions. Such fair values are based on discounted cash flow analyses reflecting the likelihood of achieving specified performance measures or events and captures the contractual nature of the contingencies, commercial risk and the time value of money. The largest outstanding contingent consideration amount relates to Health Grid and was valued at $23.9 million at September 30, 2018.

The following table summarizes our financial assets and liabilities measured at fair value on a recurring basis as of the respective balance sheet dates:

	Balance Sheet	September 30, 2018								December 31, 2017
(In thousands)	Classifications	Level 1		Level 2		Level 3		Total		Level 1		Level 2		Level 3		Total
Foreign exchange derivative assets	Prepaid expenses and other current assets	$	0	$	0	$	0	$	0	$	0	$	1,136	$	0	$	1,136
1.25% Call Option	Other assets		0		0		33,471		33,471		0		0		46,578		46,578
Contingent consideration	Other assets		0		0		3,129		3,129		0		0		2,830		2,830
Total assets		$	0	$	0	$	36,600	$	36,600	$	0	$	1,136	$	49,408	$	50,544

Foreign exchange derivative assets	Other current liabilities	$	0	$	1,560	$	0	$	1,560	$	0	$	0	$	0	$	0
Contingent consideration	Accrued expenses		0		0		12,386		12,386		0		0		2,842		2,842
Contingent consideration	Other liabilities		0		0		16,106		16,106		0		0		5,638		5,638
1.25% Embedded cash conversion option	Other liabilities		0		0		34,907		34,907		0		0		47,777		47,777
Total liabilities		$	0	$	1,560	$	63,399	$	64,959	$	0	$	0	$	56,257	$	56,257

The changes in Level 3 assets and liabilities measured at fair value on a recurring basis at September 30, 2018 are summarized as follows:

	(in thousands)
Balance at December 31, 2017	$	6,849
Additions		24,425
Payments		(3,934	)
Fair value adjustments		(541	)
Balance at September 30, 2018	$	26,799

Long-term Investments

The following table summarizes our long-term equity investments which are included in Other assets in the accompanying consolidated balance sheets:

	Number of
	Investees		Original		Carrying Value at
(In thousands, except for number of investees)	at September 30, 2018		Cost		September 30, 2018		December 31, 2017
Equity method investments ⁽¹⁾		8	$	5,658	$	7,788	$	3,258
Cost method investments		4		32,970		14,601		26,755
Total long-term equity investments		12	$	38,628	$	22,389	$	30,013

_________________________________

⁽¹⁾

Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

As of September 30, 2018, it is not practicable to estimate the fair value of our non-marketable cost and equity method investments primarily because of their illiquidity and restricted marketability. The factors we considered in trying to determine fair value include, but are not limited to, available financial information, the issuer’s ability to meet its current obligations, the issuer’s subsequent or planned raises of capital, and observable price changes in orderly transactions.

Impairment of Long-term Investments

Each quarter, we perform an assessment of our long-term equity investments on an individual basis to determine if there have been any declines in fair value. As a result of these assessments, we recognized non-cash impairment charges of $15.5 million during the nine months ended September 30, 2018 related to two of our cost-method equity investments and a related note receivable. These charges equaled the cost bases of the investments and the related note receivable prior to the impairment. The non-cash impairment charges are included in the “Impairment of long-term investments” line in our consolidated statements of operations for the nine months ended September 30, 2018. No non-cash impairment charges were recognized in the three months ended September 30, 2018.

Long-term Financial Liabilities

Our long-term financial liabilities include amounts outstanding under our senior secured credit facility and Netsmart’s non-recourse Credit Agreements (as defined in Note 8, “Debt”), with carrying values that approximate fair value since the interest rates approximate current market rates. In addition, the carrying amount of our 1.25% Cash Convertible Senior Notes (the “1.25% Notes”) approximates fair value as of September 30, 2018, since the effective interest rate on the 1.25% Notes approximates current market rates. Refer to Note 8, “Debt,” for further information regarding our long-term financial liabilities.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Stockholders' Equity

9 Months Ended

Sep. 30, 2018

Equity [Abstract]

Shareholders' Equity

5. Stockholders' Equity

Stock-based Compensation Expense

Stock-based compensation expense recognized during the three and nine months ended September 30, 2018 and 2017 is included in our consolidated statements of operations as shown in the below table. Stock-based compensation expense includes both non-cash expense related to grants of stock-based awards as well as cash expense related to the employee discount applied to purchases of our common stock under our employee stock purchase plan. In addition, the three and nine months ended September 30, 2018 and 2017 include stock-based compensation expense related to Netsmart’s time-based liability classified option awards. No stock-based compensation costs were capitalized during the three and nine months ended September 30, 2018 and 2017.

	Three Months Ended September 30,				Nine Months Ended September 30,
(In thousands)	2018		2017		2018		2017
Cost of revenue:
Software delivery, support and maintenance	$	498	$	378	$	1,565	$	2,491
Client services		1,103		899		3,679		3,464
Total cost of revenue		1,601		1,277		5,244		5,955
Selling, general and administrative expenses		7,225		7,193		20,934		17,793
Research and development		2,395		1,934		7,362		6,643
Total stock-based compensation expense	$	11,221	$	10,404	$	33,540	$	30,391

Allscripts Long-Term Incentive Plan

We measure stock-based compensation expense at the grant date based on the fair value of the award. We recognize the expense for service-based share awards over the requisite service period on a straight-line basis, net of estimated forfeitures. We recognize the expense for performance-based and market-based share awards over the vesting period under the accelerated attribution method, net of estimated forfeitures. In addition, we recognize stock-based compensation cost for awards with performance conditions if and when we conclude that it is probable that the performance conditions will be achieved.

The fair value of service-based and performance-based restricted stock units is measured at the underlying closing share price of our common stock on the date of grant. The fair value of market-based restricted stock units is measured using the Monte Carlo pricing model. No stock options were granted during the three and nine months ended September 30, 2018 and 2017.

We granted stock-based awards as follows:

	Three Months Ended September 30, 2018				Nine Months Ended September 30, 2018
			Weighted-Average				Weighted-Average
			Grant Date				Grant Date
(In thousands, except per share amounts)	Shares		Fair Value		Shares		Fair Value
Service-based restricted stock units		0	$	0.00		3,468	$	12.87
Performance-based restricted stock units with a service condition		0	$	0.00		524	$	15.74
Market-based restricted stock units with a service condition		0	$	0.00		0	$	0.00
		0	$	0.00		3,992	$	13.25

During the nine months ended September 30, 2018 and the year ended December 31, 2017, 1.5 million and 1.3 million shares of common stock, respectively, were issued in connection with the exercise of options and the release of restrictions on stock awards.

Net Share-settlements

Upon vesting, restricted stock units are generally net share-settled to cover the required withholding tax and the remaining amount is converted into an equivalent number of shares of common stock. The majority of restricted stock units and awards that vested during the nine months ended September 30, 2018 and year ended December 31, 2017 were net-share settled such that we withheld shares with fair value equivalent to the employees’ minimum statutory obligation for the applicable income and other employment taxes, and remitted the cash to the appropriate taxing authorities. Total payments for the employees' minimum statutory tax obligations to the taxing authorities are reflected as a financing activity within the accompanying consolidated statements of cash flows. The total shares withheld for the nine months ended September 30, 2018 and 2017 were 629 thousand and 569 thousand, respectively, and were based on the value of the restricted stock units on their vesting date as determined by our closing stock price. These net-share settlements had the effect of share repurchases by us as they reduced the number of shares that would have otherwise been issued as a result of the vesting.

Stock Repurchases

On November 17, 2016, we announced that our Board approved a stock purchase program (the “2016 Program”) under which we may repurchase up to $200 million of our common stock through December 31, 2019. On August 2, 2018, we announced that our Board approved a new stock purchase program (the “2018 Program”) under which we may repurchase up to $250 million of our common stock through December 31, 2020, replacing the 2016 Program. We have not repurchased any shares of our common stock under the 2018 Program as of September 30, 2018. We repurchased 7.7 million shares of our common stock under the 2016 Program for a total of $101.9 million during the nine months ended September 30, 2018, of which none were repurchased during the three months ended September 30, 2018. During the nine months ended September 30, 2017, we repurchased 1.0 million shares of our common stock under the 2016 Program for a total of $12.1 million. We repurchased no shares during the three months ended September 30, 2017. Any future stock repurchase transactions may be made through open market transactions, block trades, privately negotiated transactions (including accelerated share repurchase transactions) or other means, subject to market conditions. Any repurchase activity will depend on many factors such as our working capital needs, cash requirements for investments, debt repayment obligations, economic and market conditions at the time, including the price of our common stock, and other factors that we consider relevant. Our stock repurchase program may be accelerated, suspended, delayed or discontinued at any time.

Netsmart Stock-based Compensation Expense

Stock-based compensation expense related to Netsmart’s time-based liability classified option awards totaled $1.1 million and $3.5 million, respectively, during the three and nine months ended September 30, 2018. Stock-based compensation expense (benefit) related to Netsmart’s time-based liability classified option awards totaled $2.4 million and ($0.6) million during the three and nine months ended September 30, 2017, respectively.

At September 30, 2018, the liability for outstanding awards was $11.6 million. As of September 30, 2018, the weighted average fair value per option unit using the Black‑Scholes‑Merton option pricing model was estimated at $0.30, as compared to $0.54 at December 31, 2016. A significant portion of the decrease in fair value occurred during the first quarter of 2017 and resulted in the reversal of previously recognized stock-based compensation expense during the three months ended March 31, 2017, as required under the liability method of accounting.

During the three and nine months ended September 30, 2018, 1.4 million option unit awards were granted by Netsmart.

Earnings (Loss) Per Share

9 Months Ended

Sep. 30, 2018

Earnings Per Share [Abstract]

Earnings (Loss) Per Share

6. Earnings (Loss) Per Share

Basic earnings (loss) per share is computed by dividing net income (loss) by the weighted-average shares of common stock outstanding. For purposes of calculating diluted earnings (loss) per share, the denominator includes both the weighted-average shares of common stock outstanding and dilutive common stock equivalents. Dilutive common stock equivalents consist of stock options, restricted stock unit awards and warrants calculated under the treasury stock method.

The calculations of earnings (loss) per share are as follows:

	Three Months Ended September 30,						Nine Months Ended September 30,
(In thousands, except per share amounts)	2018			2017			2018			2017
Basic earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax	$	(23,846	)	$	(17,462	)	$	18,180		$	(169,038	)
Less: Net loss (income) attributable to non-controlling interests		4			(163	)		3,494			(352	)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart		(12,149	)		(10,962	)		(36,446	)		(32,887	)
Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(35,991	)	$	(28,587	)	$	(14,772	)	$	(202,277	)
Net (loss) income from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders		0			0			3,731			0
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(35,991	)	$	(28,587	)	$	(11,041	)	$	(202,277	)

Weighted-average common shares outstanding		174,638			180,634			176,942			180,864

Basic earnings (loss) from continuing operations per Common Share	$	(0.20	)	$	(0.16	)	$	(0.09	)	$	(1.12	)
Basic income from discontinued operations per Common Share		0.00			0.00			0.03			0.00
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(0.20	)	$	(0.16	)	$	(0.06	)	$	(1.12	)

Diluted earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax	$	(23,846	)	$	(17,462	)	$	18,180		$	(169,038	)
Less: Net loss (income) attributable to non-controlling interests		4			(163	)		3,494			(352	)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart		(12,149	)		(10,962	)		(36,446	)		(32,887	)
Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(35,991	)	$	(28,587	)	$	(14,772	)	$	(202,277	)
Net (loss) income from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders		0			0			3,731			0
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(35,991	)	$	(28,587	)	$	(11,041	)	$	(202,277	)

Weighted-average common shares outstanding		174,638			180,634			176,942			180,864
Plus: Dilutive effect of stock options, restricted stock unit awards and warrants		0			0			0			0
Weighted-average common shares outstanding assuming dilution		174,638			180,634			176,942			180,864

Diluted earnings (loss) from continuing operations per Common Share	$	(0.20	)	$	(0.16	)	$	(0.09	)	$	(1.12	)
Diluted income from discontinued operations per Common Share		0.00			0.00			0.03			0.00
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(0.20	)	$	(0.16	)	$	(0.06	)	$	(1.12	)

Due to the net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders for the three and nine months ended September 30, 2018, we used basic weighted-average common shares outstanding in the calculation of diluted loss per share for those periods, since the inclusion of any stock equivalents would be anti-dilutive.

The following stock options, restricted stock unit awards and warrants are not included in the computation of diluted earnings (loss) per share as the effect of including such stock options, restricted stock unit awards and warrants in the computation would be anti-dilutive:

Three Months Ended

September 30,

Nine Months Ended

September 30,

(In thousands)

2018

2017

2018

2017

Shares subject to anti-dilutive stock options, restricted stock

unit awards and warrants excluded from calculation

24,191

26,085

24,688

26,636

Goodwill and Intangible Assets

9 Months Ended

Sep. 30, 2018

Goodwill And Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

7. Goodwill and Intangible Assets

Goodwill and intangible assets consist of the following:

	September 30, 2018							December 31, 2017
	Gross							Gross
	Carrying		Accumulated			Intangible		Carrying		Accumulated			Intangible
(In thousands)	Amount		Amortization			Assets, Net		Amount		Amortization			Assets, Net
Intangibles subject to amortization:
Proprietary technology	$	714,983	$	(450,727	)	$	264,256	$	695,354	$	(405,114	)	$	290,240
Customer contracts and relationships		1,030,563		(500,184	)		530,379		922,492		(464,860	)		457,632
Total	$	1,745,546	$	(950,911	)	$	794,635	$	1,617,846	$	(869,974	)	$	747,872

Intangibles not subject to amortization:
Registered trademarks						$	79,000						$	79,000
Goodwill							2,207,967							2,004,953
Total						$	2,286,967						$	2,083,953

Changes in the carrying amounts of goodwill by reportable segment for the nine months ended September 30, 2018 were as follows:

	Clinical and			Population
(In thousands)	Financial Solutions			Health			Netsmart		Total
Balance as of December 31, 2017	$	861,615		$	431,132		$	712,206	$	2,004,953
Additions arising from business acquisitions:
Practice Fusion		35,234			0			0		35,234
Barista Operations, LLC		0			0			99,938		99,938
Health Grid		0			53,953			0		53,953
Other acquisitions		4,492			0			2,522		7,014
Total arising from business acquisitions		39,726			53,953			102,460		196,139
Increases (decreases) due to measurement period adjustments related to prior year acquisitions:
NantHealth provider/patient solutions business		0			117			0		117
Enterprise Information Solutions business		28,182			11,432			0		39,614
Total increases (decreases) due to measurement period adjustments:		28,182			11,549			0		39,731
Total additions to goodwill		67,908			65,502			102,460		235,870
Divestitures		0			(32,306	)		0		(32,306	)
Foreign exchange translation		(550	)		0			0		(550	)
Balance as of September 30, 2018	$	928,973		$	464,328		$	814,666		2,207,967

There were no accumulated impairment losses associated with our goodwill as of September 30, 2018 or December 31, 2017.

Other additions during the first nine months of 2018 include $4.5 million arising from Allscripts’ purchase of a cloud-based analytics software platform provider, and $2.5 million arising from Netsmart’s acquisition of a third party provider of billing solutions. Goodwill was reduced by $2.2 million due to the divestiture of our strategic sourcing business unit, and by $30.1 million related to the OneContent divestiture. Refer to Note 3, “Business Combinations,” for additional information regarding these transactions.

Effective January 1, 2018, we made organizational changes that affected our Clinical and Financial Solutions and Population Health reportable segments. As a result of these changes, the dbMotion business unit, formerly included in the Population Health operating segment within the Population Health reportable segment, is now aligned with the Hospitals and Health Systems operating segment within the Clinical and Financial solutions reportable segment. Effective July 1, 2018, we made an additional organizational change within our Clinical and Financial Solutions reportable segment. This change included the transfer of the Payerpath business unit, formerly included in the Payer and Life Sciences operating segment, to the Ambulatory operating segment. Refer to Note 14, “Business Segments,” for additional information.

We performed our annual goodwill impairment test as of October 1, 2017, our annual testing date, and again as of January 1, 2018 and July 1, 2018 in connection with the organizational changes referred to above. While there was no impairment indicated as a result of both the January 1, 2018 and July 1, 2018 tests, the estimated fair value of our Hospitals and Health Systems reporting unit exceeded the unit’s carrying value by 10%. The fair values of all other reporting units substantially exceeded their carrying values. As of March 31, 2018, the goodwill allocated to the Hospitals and Health Systems reporting unit was $511.2 million. The determination of the fair value of our reporting units is based on a combination of a market approach, that considers benchmark company market multiples, and an income approach, that utilizes discounted cash flows for each reporting unit and other Level 3 inputs. Under the income approach, we determine fair value based on the present value of the most recent cash flow projections for each reporting unit as of the date of the analysis and calculate a terminal value utilizing a terminal growth rate. The significant assumptions under this approach include, among others: income projections, which are dependent on sales to new and existing clients, new product introductions, client behavior, competitor pricing, operating expenses, the discount rate, and the terminal growth rate. The cash flows used to determine fair value are dependent on a number of significant management assumptions such as our expectations of future performance and the expected future economic environment, which are partly based upon our historical experience. Our estimates are subject to change given the inherent uncertainty in predicting future results. Additionally, the discount rate and the terminal growth rate are based on our judgment of the rates that would be utilized by a hypothetical market participant. As part of the goodwill impairment testing, we also consider our market capitalization in assessing the reasonableness of the combined fair values estimated for our reporting units. Because the fair value of the Hospitals and Health Systems reporting unit was not substantially in excess of its carrying value at January 1, 2018, there is an increased risk that any adverse trends in the foregoing assumptions with respect to the Hospitals and Health Systems reporting unit could cause the estimated fair value to fall below the carrying value, which would result in a material impairment of the reporting unit’s goodwill.

Debt

9 Months Ended

Sep. 30, 2018

Debt Disclosure [Abstract]

Debt

8. Debt

Debt outstanding, excluding capital leases, consists of the following:

	September 30, 2018						December 31, 2017
(In thousands)	Principal Balance		Unamortized Discount and Debt Issuance Costs		Net Carrying Amount		Principal Balance		Unamortized Discount and Debt Issuance Costs		Net Carrying Amount
1.25% Cash Convertible Senior Notes	$	345,000	$	25,620	$	319,380	$	345,000	$	35,978	$	309,022
Senior Secured Credit Facility		708,750		6,588		702,162		628,750		3,360		625,390
Netsmart Non-Recourse Debt:
First Lien Term Loan		642,739		10,361		632,378		479,316		10,950		468,366
Second Lien Term Loan		167,000		6,632		160,368		167,000		7,418		159,582
Total debt	$	1,863,489	$	49,201	$	1,814,288	$	1,620,066	$	57,706	$	1,562,360
Less: Debt payable within one year - excluding Netsmart		20,000		484		19,516		28,125		438		27,687
Less: Debt payable within one year - Netsmart		6,575		2,318		4,257		4,866		2,111		2,755
Total long-term debt, less current maturities	$	1,836,914	$	46,399	$	1,790,515	$	1,587,075	$	55,157	$	1,531,918

Interest expense consists of the following:

	Three Months Ended September 30,				Nine Months Ended September 30,
(In thousands)	2018		2017		2018		2017
Interest expense	$	9,353	$	5,577	$	25,437	$	15,079
Amortization of discounts and debt issuance costs		3,899		3,674		11,489		10,867
Netsmart:
Interest expense ⁽¹⁾		14,266		12,107		40,292		34,188
Amortization of discounts and debt issuance costs		970		894		2,770		2,588
Write off of unamortized deferred debt issuance costs		855		0		855		0
Total interest expense	$	29,343	$	22,252	$	80,843	$	62,722

⁽¹⁾

Includes interest expense related to capital leases.

Interest expense related to the 1.25% Notes, included in the table above, consists of the following:

	Three Months Ended September 30,				Nine Months Ended September 30,
(In thousands)	2018		2017		2018		2017
Coupon interest at 1.25%		1,078	$	1,078	$	3,234	$	3,234
Amortization of discounts and debt issuance costs		3,509		3,342		10,358		9,866
Total interest expense related to the 1.25% Notes	$	4,587	$	4,420	$	13,592	$	13,100

Allscripts Senior Secured Credit Facility

On February 15, 2018, Allscripts and Healthcare LLC entered into a Second Amended and Restated Credit Agreement (the “Second Amended Credit Agreement”), with JPMorgan Chase Bank, N.A., as administrative agent (the “Administrative Agent”), the several banks and other financial institutions or entities from time to time party thereto, and Fifth Third Bank, KeyBank National Association, SunTrust Bank and Wells Fargo Bank, National Association, as syndication agents, amending and restating the Amended and Restated Credit Agreement, dated September 30, 2015, as amended on March 28, 2016 and December 22, 2016 (the “Prior Credit Agreement”). The Second Amended Credit Agreement provides for a $400 million senior secured term loan (an increase from the $250 million term loan provided under the Prior Credit Agreement) (the “Term Loan”) and a $900 million senior secured revolving facility (an increase from the $550 million revolving facility provided under the Prior Credit Agreement) (the “Revolving Facility”), each with a five-year term. The Term Loan is repayable in quarterly installments commencing on June 30, 2018. A total of up to $50 million of the Revolving Facility is available for the issuance of letters of credit, up to $10 million of the Revolving Facility is available for swingline loans, and up to $100 million of the Revolving Facility could be borrowed under certain foreign currencies. Proceeds from the borrowings under the Second Amended Credit Agreement were used for the refinancing of indebtedness under the Prior Credit Agreement.

The proceeds of the Revolving Facility can be used to finance Allscripts’ working capital needs and for general corporate purposes, including, without limitation, financing of permitted acquisitions, and for share repurchases. Allscripts is also permitted to add one or more incremental revolving and/or term loan facilities in an aggregate amount of up to $600 million, subject to certain conditions (an increase from the $300 million incremental facility permitted under the Prior Credit Agreement).

The initial applicable interest rate margin for Base Rate borrowings is 1.00%, and for Eurocurrency Rate borrowings is 2.00%. On and after September 30, 2018, the interest rate margins will be determined from a pricing table and will depend upon Allscripts’ total leverage ratio. The applicable margins for Base Rate borrowings under the Second Amended Credit Agreement range from 0.50% to 1.25% depending on Allscripts’ total leverage ratio (as compared to the 0.00% to 1.25% range provided under the Prior Credit Agreement). The applicable margins for Eurocurrency Rate loans range from 1.50% to 2.25%, depending on Allscripts’ total leverage ratio (as compared to the 1.00% to 2.25% range provided under the Prior Credit Agreement).

As of September 30, 2018, $390.0 million under the Term Loan, $318.8 million under the Revolving Facility, and $0.8 million in letters of credit were outstanding under the Second Amended Credit Agreement.

As of September 30, 2018, the interest rate on the borrowings under the Second Amended Credit Agreement was LIBOR plus 2.00%, which totaled 4.24%. We were in compliance with all covenants under the Second Amended Credit Agreement as of September 30, 2018.

As of September 30, 2018, we had $580.4 million available, net of outstanding letters of credit, under our Revolving Facility. There can be no assurance that we will be able to draw on the full available balance of our Revolving Facility if the financial institutions that have extended such credit commitments become unwilling or unable to fund such borrowings.

As of September 30, 2018, the if-converted value of the 1.25% Notes did not exceed the 1.25% Notes’ principal amount.

Netsmart Non-Recourse Debt

During the three months ended September 30, 2018, Netsmart amended its First and Second Lien Credit Agreements in order to finance the acquisition of Barista on July 2, 2018. The changes to the credit agreements included an increase to the principal of the First Lien Credit Agreement by $167.5 million and reductions to the interest rate spreads under the First Lien Credit Agreement from 4.5% to 3.75% (plus LIBOR) and under the Second Lien Credit Agreement from 9.5% to 7.5% (plus LIBOR). New debt issuance costs of $2.2 million were capitalized in connection with the amendments, while previously capitalized debt issuance costs $0.9 million were written off to interest expense due to changes in members of the lending syndicate.

As of September 30, 2018, $642.7 million under the Netsmart First Lien Term Loan, $167.0 million under the Netsmart Second Lien Term Loan and no amounts under the Netsmart Revolving Facility (collectively, the “Netsmart Credit Agreements”) were outstanding.

As of September 30, 2018, the interest rate on the borrowings under the Netsmart First Lien Term Loan was Adjusted LIBO rate plus 3.75%, which totaled 5.83%, the interest rate on the borrowings under the Netsmart Second Lien Term Loan was Adjusted LIBO rate plus 7.50%, which totaled 9.84%, and the interest rate on the borrowings under the Netsmart Revolving Facility was Adjusted LIBO rate plus 4.75%, which totaled 6.83%. Netsmart was in compliance with all covenants under the Netsmart Credit Agreements as of September 30, 2018.

As of September 30, 2018, Netsmart had $50.0 million available, with no outstanding letters of credit commitments, under the Netsmart Revolving Facility. There can be no assurance that Netsmart will be able to draw on the full available balance of the Netsmart Revolving Facility if the financial institutions that have extended such credit commitments become unwilling or unable to fund such borrowings.

The following table summarizes future debt payment obligations as of September 30, 2018:


(In thousands)	Total		Remainder of 2018		2019		2020		2021		2022		Thereafter
1.25% Cash Convertible Senior Notes ⁽¹⁾	$	345,000	$	0	$	0	$	345,000	$	0	$	0	$	0
Term Loan		390,000		5,000		20,000		27,500		30,000		37,500		270,000
Revolving Facility ⁽²⁾		318,750		0		0		0		0		0		318,750
Netsmart Non-Recourse Debt ⁽²⁾
First Lien Term Loan ⁽³⁾		642,739		1,644		6,575		6,575		6,575		6,575		614,795
Second Lien Term Loan		167,000		0		0		0		0		0		167,000
Total debt	$	1,863,489	$	6,644	$	26,575	$	379,075	$	36,575	$	44,075	$	1,370,545

⁽¹⁾ Assumes no cash conversions of the 1.25% Notes prior to their maturity on July 1, 2020.

⁽²⁾ Assumes no additional borrowings after September 30, 2018, payment of any required periodic installments of principal and that all drawn amounts are repaid upon maturity.

⁽³⁾ Starting with the year ended December 31, 2017, additional amounts may be due within 125 days after year-end if Netsmart has “excess cash” as defined in the Netsmart Credit Agreement.

Income Taxes

9 Months Ended

Sep. 30, 2018

Income Tax Disclosure [Abstract]

Income Taxes

9. Income Taxes

We account for income taxes under FASB Accounting Standards Codification 740, Income Taxes (“ASC 740”). We calculate the quarterly tax provision consistent with the guidance provided by ASC 740-270, whereby we forecast the estimated annual effective tax rate and then apply that rate to the year-to-date pre-tax book (loss) income. The effective tax rate may be subject to fluctuations during the year as new information is obtained, which may affect the assumptions used to estimate the annual effective rate, including factors such as the valuation allowances against deferred tax assets, the recognition or de-recognition of tax benefits related to uncertain tax positions, or changes in or the interpretation of tax laws in jurisdictions where the Company conducts business. There is no tax benefit recognized on certain of the net operating losses incurred due to insufficient evidence supporting the Company’s ability to use these losses in the future. The effective tax rates were as follows:

	Three Months Ended September,						Nine Months Ended September,
(In thousands)	2018			2017			2018			2017
(Loss) income from continuing operations before income taxes	$	(27,635	)	$	(17,700	)	$	15,160		$	(170,111	)
Income tax benefit	$	3,789		$	238		$	3,020		$	1,073
Effective tax rate		13.7	%		1.3	%		(19.9	%)		0.6	%

The United States Tax Cuts and Jobs Act (the “Tax Act”) was enacted on December 22, 2017 and introduced significant changes to the income tax law in the United States. Effective in 2018, the Tax Act reduces the United States statutory tax rate from 35% to 21% and creates new taxes on certain foreign-sourced earnings and certain related-party payments, which are referred to as the Global Intangible Low-taxed Income ("GILTI") tax and Base Erosion and Anti-Abuse Tax (“BEAT”) rules, respectively. In addition, in 2017 we were subject to a one-time transition tax on accumulated foreign subsidiary earnings not previously subject to income tax in the United States.

Due to the timing of the enactment and the complexity involved in applying the provisions of the Tax Act, we made reasonable estimates of the effects and recorded provisional benefit of $20.8 million in our financial statements for the year ended December 31, 2017 in accordance with guidance in Staff Accounting Bulletin No. 118 (“SAB 118”), which allows a measurement period of up to one year after the enactment date to finalize the recording of the related tax impacts. This provisional benefit includes $26 million benefit for remeasurement of deferred tax balances to reflect the lower federal rate and expense of $5.2 million for the one-time transition tax on accumulated foreign subsidiary earnings not previously subject to income tax in the United States. We will complete our analysis of the Tax Act by December 22, 2018, and any needed adjustments to the provisional amounts will be included in income tax expense or benefit in the fourth quarter of 2018, in accordance with SAB 118. We are continuing to assess the impacts of the Tax Act on the 2018 effective tax rate and income tax accounting, particularly the GILTI tax and BEAT rules.

Our provision for income taxes differs from the tax computed at the U.S. federal statutory income tax rate due primarily to valuation allowance, permanent differences, income attributable to foreign jurisdictions taxed at lower rates, state taxes, tax credits and certain discrete items. Our effective tax rate for the three and nine months ended September 30, 2018, compared with the prior year comparable period, differs primarily due to the reduced United States federal statutory rate, the estimated impact of the GILTI and BEAT provisions and the stricter executive compensation deduction provisions of the Tax Act, reflected in the provision for the three and nine months ended September 30, 2018.

In evaluating our ability to recover our deferred tax assets within the jurisdictions from which they arise, we consider all available evidence, including scheduled reversals of deferred tax liabilities, tax-planning strategies, and results of recent operations. In evaluating the objective evidence that historical results provide, we consider three years of cumulative operating income (loss). During the nine months ended September 30, 2018, we released $14.4 million of valuation allowance, mostly due to the utilization of capital loss carryforward against capital gain incurred during the nine months ended September 30, 2018.

Our unrecognized income tax benefits were $12.6 million and $12.0 million as of September 30, 2018 and December 31, 2017, respectively. If any portion of our unrecognized tax benefits is recognized, it could impact our effective tax rate. The tax reserves are reviewed periodically and adjusted in light of changing facts and circumstances, such as progress of tax audits, lapse of applicable statutes of limitations, and changes in tax law.

Derivative Financial Instruments

9 Months Ended

Sep. 30, 2018

Derivative Instruments And Hedging Activities Disclosure [Abstract]

Derivative Financial Instruments

10. Derivative Financial Instruments

The following tables provide information about the fair values of our derivative financial instruments as of the respective balance sheet dates:

September 30, 2018

Asset Derivatives

Liability Derivatives

(In thousands)

Balance Sheet Location

Fair Value

Balance Sheet Location

Fair Value

Derivatives qualifying as cash flow hedges:

Foreign exchange contracts

Prepaid expenses and

other current assets

Accrued expenses

1,560

Derivatives not subject to hedge accounting:

1.25% Call Option

Other assets

33,471

N/A

1.25% Embedded cash conversion option

N/A

Other liabilities

34,907

Total derivatives

33,471

36,467

December 31, 2017

Asset Derivatives

Liability Derivatives

(In thousands)

Balance Sheet Location

Fair Value

Balance Sheet Location

Fair Value

Derivatives qualifying as cash flow hedges:

Foreign exchange contracts

Prepaid expenses and

other current assets

1,136

Accrued expenses

Derivatives not subject to hedge accounting:

1.25% Call Option

Other assets

46,578

N/A

1.25% Embedded cash conversion option

N/A

Other liabilities

47,777

Total derivatives

47,714

47,777

N/A – We define “N/A” as disclosure not being applicable

Foreign Exchange Contracts

We have entered into non-deliverable forward foreign currency exchange contracts with reputable banking counterparties in order to hedge a portion of our forecasted future Indian Rupee-denominated (“INR”) expenses against foreign currency fluctuations between the United States dollar and the INR. These forward contracts cover a decreasing percentage of forecasted monthly INR expenses over time. As of September 30, 2018, there were 15 forward contracts outstanding that were staggered to mature monthly starting in October 2018 and ending in December 2019. In the future, we may enter into additional forward contracts to increase the amount of hedged monthly INR expenses or initiate hedges for monthly periods beyond December 2019. As of September 30, 2018, the total notional amount of the outstanding forward contracts ranged from 160 to 190 million INR, or the equivalent of $2.2 million to $2.6 million, based on the exchange rate between the United States dollar and the INR in effect as of September 30, 2018. These amounts also approximate the forecasted future INR expenses we target to hedge in any one month in the future.

The critical terms of the forward contracts and the related hedged forecasted future expenses matched and allowed us to designate the forward contracts as highly effective cash flow hedges. The effective portion of the change in fair value is initially recorded in accumulated other comprehensive loss (“AOCI”) and subsequently reclassified to income in the period in which the cash flows from the associated hedged transactions affect income. Any ineffective portion of the change in fair value of the cash flow hedges is recognized in current period income. During the three and nine months ended September 30, 2018, no amount was excluded from the effectiveness assessment and no gains or losses were reclassified from AOCI into income as a result of forecasted transactions that failed to occur. As of September 30, 2018, we estimate that $1.6 million of net unrealized derivative losses included in AOCI will be reclassified into income within the next twelve months.

The following tables show the impact of derivative instruments designated as cash flow hedges on the consolidated statements of operations and the consolidated statements of comprehensive loss:

	Amount of Gain (Loss) Recognized in OCI (Effective Portion)							Amount of Gain (Loss) Reclassified from AOCI into Income (Effective Portion)
(In thousands)	Three Months Ended September 30, 2018			Nine Months Ended September 30, 2018			Location of Gain (Loss) Reclassified from AOCI into Income (Effective Portion)	Three Months Ended September 30, 2018			Nine Months Ended September 30, 2018
Foreign exchange contracts	$	(1,803	)	$	(2,010	)	Cost of Revenue	$	(74	)	$	227
							Selling, general and administrative expenses		(50	)		180
							Research and development	$	(77	)	$	278

	Amount of Gain (Loss) Recognized in OCI (Effective Portion)					Amount of Gain (Loss) Reclassified from AOCI into Income (Effective Portion)
(In thousands)	Three Months Ended September 30, 2017		Nine Months Ended September 30, 2017		Location of Gain (Loss) Reclassified from AOCI into Income (Effective Portion)	Three Months Ended September 30, 2017		Nine Months Ended September 30, 2017
Foreign exchange contracts	$	16	$	2,323	Cost of Revenue	$	241	$	674
					Selling, general and administrative expenses		184		515
					Research and development	$	283	$	793

1.25% Call Option

In June 2013, concurrent with the issuance of the 1.25% Notes, we entered into privately negotiated hedge transactions with certain of the initial purchasers of the 1.25% Notes (collectively, the “1.25% Call Option”). Assuming full performance by the counterparties, the 1.25% Call Option is intended to offset cash payments in excess of the principal amount due upon any conversion of the 1.25% Notes.

The 1.25% Call Option, which is indexed to our common stock, is a derivative asset that requires mark-to-market accounting treatment (due to the cash settlement features) until the 1.25% Call Option settles or expires. The 1.25% Call Option is measured and reported at fair value on a recurring basis, within Level 3 of the fair value hierarchy. For further discussion of the inputs used to determine the fair value of the 1.25% Call Option, refer to Note 4, “Fair Value Measurements and Long-term Investments.”

The 1.25% Call Option does not qualify for hedge accounting treatment. Therefore, the change in fair value of these instruments is recognized immediately in our consolidated statements of operations in Other income, net. Because the terms of the 1.25% Call Option are substantially similar to those of the 1.25% Notes embedded cash conversion option, discussed below, we expect the net effect of those two derivative instruments on our earnings to be minimal.

1.25% Notes Embedded Cash Conversion Option

The embedded cash conversion option within the 1.25% Notes is required to be separated from the 1.25% Notes and accounted for separately as a derivative liability, with changes in fair value reported in our consolidated statements of operations in Other income, net until the cash conversion option settles or expires. The initial fair value liability of the embedded cash conversion option was $82.8 million, which simultaneously reduced the carrying value of the 1.25% Notes (effectively an original issuance discount). The embedded cash conversion option is measured and reported at fair value on a recurring basis, within Level 3 of the fair value hierarchy. For further discussion of the inputs used to determine the fair value of the embedded cash conversion option, refer to Note 4, “Fair Value Measurements and Long-term Investments.”

The following table shows the net impact of the changes in fair values of the 1.25% Call Option and the 1.25% Notes’ embedded cash conversion option in the consolidated statements of operations:

	Three Months Ended September 30,						Nine Months Ended September 30,
(In thousands)	2018			2017			2018			2017
1.25% Call Option	$	15,043		$	12,837		$	(13,108	)	$	27,802
1.25% Embedded cash conversion option		(15,503	)		(13,043	)		12,870			(28,314	)
Net loss included in other income, net	$	(460	)	$	(206	)	$	(238	)	$	(512	)

Other Comprehensive Income

9 Months Ended

Sep. 30, 2018

Equity [Abstract]

Other Comprehensive Income

11. Other Comprehensive Income

Accumulated Other Comprehensive Loss

Changes in the balances of each component included in AOCI are presented in the tables below. All amounts are net of tax and exclude non-controlling interest.

(In thousands)	Foreign Currency Translation Adjustments			Unrealized Net Gains on Foreign Exchange Contracts			Total
Balance as of December 31, 2017 ⁽¹⁾	$	(2,676	)	$	691		$	(1,985	)
Other comprehensive loss before reclassifications		(1,622	)		(1,487	)		(3,109	)
Net gains reclassified from accumulated other comprehensive loss		0			(358	)		(358	)
Net other comprehensive loss		(1,622	)		(1,845	)		(3,467	)
Balance as of September 30, 2018 ⁽²⁾	$	(4,298	)	$	(1,154	)	$	(5,452	)

^{______________________________________________________}

⁽¹⁾

Net of taxes of $445 thousand for unrealized net gains on foreign exchange contract derivatives.

⁽²⁾

Net of taxes of $405 thousand for unrealized net losses on foreign exchange contract derivatives.

^{____________________________________________________________________________}

(In thousands)	Foreign Currency Translation Adjustments			Unrealized Net Losses on Available for Sale Securities ⁽¹⁾			Unrealized Net Gains on Foreign Exchange Contracts			Total
Balance as of December 31, 2016 ⁽²⁾	$	(6,028	)	$	(56,420	)	$	619		$	(61,829	)
Other comprehensive income (loss) before reclassifications		3,040			(106,355	)		1,421			(101,894	)
Net losses (gains) reclassified from accumulated other comprehensive loss		0			162,865			(1,209	)		161,656
Net other comprehensive income		3,040			56,510			212			59,762
Balance as of September 30, 2017⁽³⁾	$	(2,988	)	$	90		$	831		$	(2,067	)

⁽¹⁾ Majority of unrealized losses as of December 31, 2016 relates to decline in fair value of NantHealth common stock.

⁽²⁾

Net of taxes of $402 thousand for unrealized net gains on foreign exchange contract derivatives and $61 thousand for unrealized net gains on available for sale securities.

⁽³⁾

Net of taxes of $531 thousand for unrealized net gains on foreign exchange contract derivatives and $58 thousand for unrealized net gains on available for sale securities.

Income Tax Effects Related to Components of Other Comprehensive Income (Loss)

The following tables reflect the tax effects allocated to each component of other comprehensive income (loss) (“OCI”):

	Three Months Ended September 30,
	2018									2017
(In thousands)	Before-Tax Amount			Tax Effect			Net Amount			Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	(60	)	$	0		$	(60	)	$	693		$	0		$	693
Available for sale securities:
Net loss arising during the period		0			0			0			(20,704	)		1			(20,703	)
Net loss reclassified into income		0			0			0			20,700			0			20,700
Net change in unrealized (losses) gains on available for sale securities		0			0			0			(4	)		1			(3	)
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net (losses) gains arising during the period		(1,803	)		468			(1,335	)		16			(6	)		10
Net losses (gains) reclassified into income ⁽¹⁾		201			(52	)		149			(708	)		276			(432	)
Net change in unrealized (losses) gains on foreign exchange contracts		(1,602	)		416			(1,186	)		(692	)		270			(422	)
Net (loss) gain on cash flow hedges		(1,602	)		416			(1,186	)		(692	)		270			(422	)
Other comprehensive (loss) income	$	(1,662	)	$	416		$	(1,246	)	$	(3	)	$	271		$	268

____________________________________________

⁽¹⁾

Tax effects for the three months ended September 30, 2018 include $149 thousand arising from the revaluation of tax effects included in accumulated other comprehensive income at December 31, 2017.

	Nine Months Ended September 30,
	2018								2017
(In thousands)	Before-Tax Amount			Tax Effect		Net Amount			Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	(1,622	)	$	0	$	(1,622	)	$	3,040		$	0		$	3,040
Available for sale securities:
Net loss arising during the period		0			0		0			(106,358	)		3			(106,355	)
Net loss reclassified into income		0			0		0			162,865			0			162,865
Net change in unrealized gains on available for sale securities		0			0		0			56,507			3			56,510
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net (losses) gains arising during the period		(2,010	)		522		(1,488	)		2,323			(902	)		1,421
Net (gains) losses reclassified into income ⁽¹⁾		(685	)		328		(357	)		(1,982	)		773			(1,209	)
Net change in unrealized (losses) gains on foreign exchange contracts		(2,695	)		850		(1,845	)		341			(129	)		212
Net (loss) gain on cash flow hedges		(2,695	)		850		(1,845	)		341			(129	)		212
Other comprehensive (loss) income	$	(4,317	)	$	850	$	(3,467	)	$	59,888		$	(126	)	$	59,762

(1)

Tax effects for the nine months ended September 30, 2018 include $149 thousand arising from the revaluations of tax effects included in accumulated other comprehensive income at December 31, 2017.

Contingencies	9 Months Ended
Contingencies	Sep. 30, 2018
Commitments And Contingencies Disclosure [Abstract]
Contingencies	12. Contingencies In addition to commitments and obligations in the ordinary course of business, we are currently subject to various legal proceedings and claims that have not been fully adjudicated. We intend to vigorously defend ourselves in these matters. No less than quarterly, we review the status of each significant matter and assess our potential financial exposure. We accrue a liability for an estimated loss if the potential loss from any legal proceeding or claim is considered probable and the amount can be reasonably estimated. Significant judgment is required in both the determination of probability and the determination as to whether the amount of an exposure is reasonably estimable, and accruals are based only on the information available to our management at the time the judgment is made. The outcome of legal proceedings is inherently uncertain, and we may incur substantial defense costs and expenses defending any of these matters. In the opinion of our management, the ultimate disposition of pending legal proceedings or claims will not have a material adverse effect on our consolidated financial position, liquidity or results of operations. However, if one or more of these legal proceedings were resolved against us in a reporting period for amounts in excess of our management’s expectations, our consolidated financial statements for that reporting period could be materially adversely affected. Additionally, the resolution of a legal proceeding against us could prevent us from offering our products and services to current or prospective clients or cause us to incur increased compliance costs, either of which could further adversely affect our operating results. On May 1, 2012, Physicians Healthsource, Inc. filed a class action complaint in the U.S. District Court for the Northern District of Illinois against us. The complaint alleges that, on multiple occasions between July 2008 and December 2011, we or our agent sent advertisements by fax to the plaintiff and a class of similarly situated persons, without first receiving the recipients’ express permission or invitation in violation of the Telephone Consumer Protection Act, 47 U.S.C. § 227 (the “TCPA”). The plaintiff sought $500 for each alleged violation of the TCPA, treble damages if the Court finds the violations to be willful, knowing or intentional, and injunctive and other relief. Allscripts answered the complaint denying all material allegations and asserting a number of affirmative defenses, as well as counterclaims for breach of a license agreement. On March 31, 2016, plaintiff filed its motion for class certification. On May 31, 2016, we filed our opposition to plaintiff’s motion for class certification, and simultaneously moved for summary judgment on all of plaintiff’s claims. On June 2, 2017, an order was entered denying class certification and, accordingly, the case will not proceed on a class-wide basis. The EIS Business acquired from McKesson on October 2, 2017 is subject to a May 2017 civil investigative demand (“CID”) from the U.S. Attorney’s Office for the Eastern District of New York. The CID requests documents and information related to the certification McKesson obtained for Horizon Clinicals in connection with the U.S. Department of Health and Human Services’ Electronic Health Record Incentive Program. In August 2018, McKesson received an additional CID seeking similar information for Paragon. McKesson has agreed, with respect to the CIDs, to indemnify Allscripts for amounts paid or payable to the government (or any private relator) involving any products or services marketed, sold or licensed by the EIS Business as of or prior to the closing of the acquisition. To date, there has been no claim or legal proceeding against Allscripts related to this investigation. Practice Fusion, acquired by Allscripts on February 13, 2018, received in March 2017 a request for documents and information from the U.S. Attorney’s Office for the District of Vermont pursuant to a CID. In April 2018 and August 2018, Practice Fusion received additional requests for documents and information. These CIDs relate to the certification Practice Fusion obtained in connection with the U.S. Department of Health and Human Services’ Electronic Health Record Incentive Program, compliance with the Anti-Kickback Statute and related business practices. To date, there has been no claim or legal proceeding against Practice Fusion related to this investigation. On January 25, 2018, a complaint was filed in Surfside Non-Surgical Orthopedics, P.A. v. Allscripts Healthcare Solutions, Inc., No. 1:18-cv-00566, in the Northern District of Illinois. This is a purported class action lawsuit related to a January 18, 2018 ransomware attack, and alleges the following counts: (1) negligence, gross negligence and negligence per se; (2) breach of contract; (3) unjust enrichment; (4) violation of the Illinois Consumer Fraud Act; and (5) violation of the Illinois Deceptive Trade Practices Act. Plaintiff seeks to represent a class of customers seeking damages from Allscripts. Allscripts has moved to dismiss the Plaintiff’s complaint.

Discontinued Operations

9 Months Ended

Sep. 30, 2018

Discontinued Operations And Disposal Groups [Abstract]

Discontinued Operations

13. Discontinued Operations

Divestitures

Two of the product offerings acquired with the EIS Business, Horizon Clinicals and Series2000 Revenue Cycle, were sunset after March 31, 2018. The decision to discontinue maintaining and supporting these solutions was made prior to our acquisition of the EIS Business and, therefore, are presented below as discontinued operations. Until the end of the first quarter of 2018, we were involved in ongoing maintenance and support for these solutions until customers have transitioned to other platforms. No disposal gains or losses were recognized during the three and nine months ended September 30, 2018 related to these discontinued operations.

The following table summarizes the major classes of assets and liabilities of the discontinued operations specifically with the sunset businesses of Horizon Clinicals and Series2000 Revenue Cycle, as reported on the consolidated balance sheets as of the dates indicated:


(In thousands)	September 30, 2018		December 31, 2017
Carrying amounts of major classes of assets associated with Horizon Clinicals and Series2000 Revenue Cycle included as part of discontinued operations:
Accounts receivable, net	$	0	$	8,196
Prepaid expenses and other current assets		0		3,080
Total assets attributable to discontinued operations	$	0	$	11,276

Carrying amounts of major classes of liabilities associated with Horizon Clinicals and Series2000 Revenue Cycle included as part of discontinued operations:
Accounts payable	$	0	$	114
Accrued expenses		2,261		5,599
Accrued compensation and benefits		0		7,728
Deferred revenue		0		7,241
Other classes of liabilities that are not major		0		676
Total liabilities attributable to discontinued operations	$	2,261	$	21,358

The following table summarizes the major classes of line items constituting income (loss) of the discontinued operations specifically with the sunset businesses of Horizon Clinicals and Series2000 Revenue Cycle, as reported in the consolidated statements of operations for the three and nine months ended September 30, 2018.

	Three months ended		Nine months ended
(In thousands)	September 30, 2018		September 30, 2018
Major classes of line items constituting pretax profit (loss) of discontinued operations for Horizon Clinicals and Series2000 Revenue Cycle:
Revenue:
Software delivery, support and maintenance	$	0	$	9,441
Client services		0		404
Total revenue		0		9,845
Cost of revenue:
Software delivery, support and maintenance		0		2,322
Client services		0		830
Total cost of revenue		0		3,152
Gross profit		0		6,693
Selling, general and administrative expenses		0		0
Research and development		0		1,651
Income from discontinued operations for Horizon Clinicals and Series2000 Revenue Cycle before income taxes		0		5,042
Income tax provision		0		(1,311	)
Income from discontinued operations, net of tax for Horizon Clinicals and Series2000 Revenue Cycle	$	0	$	3,731

During the three and nine months ended September 30, 2018, the Horizon Clinicals and Series2000 Revenue Cycle discontinued operations used $2.2 million and $3.4 million of cash, respectively.

Business Segments

9 Months Ended

Sep. 30, 2018

Segment Reporting [Abstract]

Business Segments

14. Business Segments

We primarily derive our revenues from sales of our proprietary software (either as a direct license sale or under a subscription delivery model), which also serves as the basis for our recurring service contracts for software support and maintenance and certain transaction-related services. In addition, we provide various other client services, including installation, and managed services such as outsourcing, private cloud hosting and revenue cycle management.

During the first quarter of 2018, in an effort to further streamline and align our operating structure around our key acute and population health management solutions, we made several changes to our organizational and reporting structure. These changes included the split of our former Population Health operating segment into several components. The dbMotion business unit, formerly included in the Population Health operating segment, is now aligned with the Hospitals and Health Systems operating segment within the Clinical and Financial solutions reportable segment. The Care Management, Referral Management and Careport business units, formally included in the Population Health operating segment, were combined into a new CarePort operating segment within the Population Health reportable segment. The prior period segment disclosures below were revised to conform to the current year presentation.

During the second quarter of 2018, we changed the presentation of certain research and development expenses related to common solutions and resources that benefit all of our business units, other than Netsmart. Such expenses were previously internally allocated to our business units. Under the new presentation, such expenses are no longer internally allocated and are included as part of “Unallocated Amounts.” The gross profit and income from operations previously reported for the three and nine months ended September 30, 2017 have been recast to match the new presentation. As a result, the gross profit and income from operations of the Clinical and Financial Solutions reportable segment increased by nil and $12 million, respectively, for the three months ended September 30, 2017 and by $2 million and $33 million, respectively, for the nine months ended September 30, 2017. In addition, the gross profit and income from operations of the Population Health reportable segment increased by nil and $1 million, respectively, for both the three and nine months ended September 30, 2017.

During the third quarter of 2018, as part of our continued efforts to improve operating efficiency and offer innovative products and services, we transferred the Payerpath business unit, formerly included in the Payer and Life Sciences operating segment, to the Ambulatory operating segment. This transfer had no impact on our reportable segments since both the Ambulatory and Payer and Life Sciences operating segments are included within the Clinical and Financial Solutions reportable segment.

As of September 30, 2018, we had ten operating segments, which are aggregated into three reportable segments. The Clinical and Financial Solutions reportable segment includes the Hospitals and Health Systems, Ambulatory, Payer and Life Sciences, and EIS-Classics strategic business units, each of which represents a separate operating segment. This reportable segment derives its revenue from the sale of integrated clinical software applications and financial and information solutions, which primarily include EHR-related software, connectivity and coordinated care solutions, financial and practice management software, related installation, support and maintenance, outsourcing, private cloud hosting, revenue cycle management, training and electronic claims administration services. The Population Health reportable segment is comprised of five separate operating segments: CarePort, FollowMyHealth^®, EPSi^TM, EIS-EWS and NantHealth. This reportable segment derives its revenue from the sale of health management, financial management and patient engagement solutions, which are mainly targeted at hospitals, health systems, other care facilities and Accountable Care Organizations (“ACOs”). These solutions enable clients to transition, analyze and coordinate care across the entire care community. This segment also provides document, content and supply chain management solutions through the EIS-EWS operating segment. Refer to Note 3, “Business Combinations” for additional information regarding the sale of the Strategic Sourcing and OneContent business units, respectively, which together comprise a substantial majority of the EIS-EWS operating segment. The Netsmart reportable segment is comprised of the Netsmart strategic business unit, which represents a separate operating segment. Netsmart operates in the home care and behavioral healthcare information technology field throughout the United States and provides software and technology solutions to the health and human services industry, which comprises behavioral health, addiction treatment, intellectual and developmental disability services, child and family services, and public health segment, as well as to post-acute home care organizations.

The results of operations related to two of the product offerings acquired with the EIS Business are presented throughout these financial statements as discontinued operations and are included in the Clinical and Financial Solutions reportable segment, except for acquisition-related deferred revenue adjustments, which are included in “Unallocated Amounts”. Refer to Note 13, “Discontinued Operations”.

Our Chief Operating Decision Maker (“CODM”) uses segment revenues, gross profit and income from operations as measures of performance and to make decisions on allocation of resources. With the exception of the Netsmart segment, in determining these performance measures, we do not include in revenue the amortization of acquisition-related deferred revenue adjustments, which reflect the fair value adjustments to deferred revenues acquired in a business acquisition. With the exception of the Netsmart segment, we also exclude the amortization of intangible assets, stock-based compensation expense, non-recurring expenses and transaction-related costs, and non-cash asset impairment charges from the operating segment data provided to our CODM. Non-recurring expenses relate to certain severance, product consolidation, legal, consulting and other charges incurred in connection with activities that are considered one-time. Accordingly, these amounts are not included in our reportable segment results and are included in an “Unallocated Amounts” category within our segment disclosure. The “Unallocated Amounts” category also includes (i) corporate general and administrative expenses (including marketing expenses) and certain research and development expenses related to common solutions and resources that benefit all of our business units (refer to discussion above), all of which are centrally managed, and (ii) revenue and the associated cost from the resale of certain ancillary products, primarily hardware, other than the respective amounts associated with the Netsmart segment. The Netsmart segment, as presented, includes all revenue and expenses incurred by Netsmart since it operates as a stand-alone business entity and its resources allocation and performance are reviewed and measured at such all-inclusive level. The eliminations of intercompany transactions between Allscripts and Netsmart are included in the “Unallocated Amounts” category. We do not track our assets by segment.

	Three Months Ended September 30,						Nine Months Ended September 30,
(In thousands)	2018			2017			2018			2017
Revenue:
Clinical and Financial Solutions	$	381,461		$	319,496		$	1,144,937		$	919,787
Population Health		59,678			44,523			186,451			130,460
Netsmart		92,082			83,618			260,934			235,046
Unallocated Amounts		(10,942	)		1,805			(20,695	)		3,715
Discontinued Operations		0			0			(9,845	)		0
Total revenue	$	522,279		$	449,442		$	1,561,782		$	1,289,008

Gross Profit:
Clinical and Financial Solutions	$	159,100		$	136,855		$	478,822		$	383,546
Population Health		44,941			36,130			139,516			106,948
Netsmart		40,445			39,644			115,623			111,489
Unallocated Amounts		(26,115	)		(10,710	)		(75,258	)		(33,921	)
Discontinued Operations		0			0			(6,694	)		0
Total gross profit	$	218,371		$	201,919		$	652,009		$	568,062

Income (loss) from operations:
Clinical and Financial Solutions	$	83,665		$	82,091		$	245,313		$	220,364
Population Health		30,671			28,168			93,777			84,730
Netsmart		2,191			7,153			5,723			23,910
Unallocated Amounts		(114,117	)		(92,039	)		(400,478	)		(271,264	)
Discontinued Operations		0			0			(5,042	)		0
Total income (loss) from operations	$	2,410		$	25,373		$	(60,707	)	$	57,740

Supplemental Disclosures

9 Months Ended

Sep. 30, 2018

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Supplemental Disclosures

15. Supplemental Disclosures

Supplemental Consolidated Statements of Cash Flows Information

The majority of the restricted cash balance as of September 30, 2018 and 2017 represents Netsmart’s cash deposits to maintain two letters of credit with a financial institution related to customer agreements and an escrow fund related to a previous acquisition associated with the acquired EIS Business.

	September 30,
(In thousands)	2018		2017
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents	$	111,775	$	104,301
Restricted cash		8,016		5,123
Total cash, cash equivalents and restricted cash	$	119,791	$	109,424


	Nine Months Ended September 30,
(In thousands)	2018		2017
Supplemental non-cash information:
Exchange of NantHealth, Inc. common stock for net assets acquired of provider/patient solutions business	$	0	$	42,750
Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart	$	36,446	$	32,887
Obligations incurred to purchase capitalized software or enter into capital leases	$	6,389	$	11,515
Contribution of assets in exchange for equity interest	$	4,000	$	0
Issuance of treasury stock to commercial partner	$	1,121	$	334

Asset Impairment Charges

During the nine months ended September 30, 2018, we recognized non-cash asset impairment charges of $30.1 million related to the write-off of purchased third-party software as a result of our decision to discontinue several software development projects. No non-cash asset impairment charges were recognized during the three months ended September 30, 2018.

Basis of Presentation and Significant Accounting Policies (Policies)

9 Months Ended

Sep. 30, 2018

Accounting Policies [Abstract]

Principles of Consolidation

The consolidated financial statements include the accounts of Allscripts Healthcare Solutions, Inc. (“Allscripts”) and its wholly-owned subsidiaries and controlled affiliates. All significant intercompany balances and transactions have been eliminated. Each of the terms “we,” “us,” “our” or the “Company” as used herein refers collectively to Allscripts Healthcare Solutions, Inc. and its wholly-owned subsidiaries and controlled affiliates, unless otherwise stated.

Unaudited Interim Financial Information

The unaudited interim consolidated financial statements as of and for the three and nine months ended September 30, 2018 and 2017 have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission (the “SEC”) for interim financial reporting. These interim consolidated financial statements are unaudited and, in the opinion of our management, include all adjustments, consisting of normal recurring adjustments and accruals, necessary to present fairly the consolidated financial statements for the periods presented in accordance with generally accepted accounting principles in the United States of America (“GAAP”). The consolidated results of operations for the three and nine months ended September 30, 2018 are not necessarily indicative of the results to be expected for the full year ending December 31, 2018.

Certain information and footnote disclosures normally included in annual financial statements prepared in accordance with GAAP have been condensed or omitted in accordance with the SEC's rules and regulations for interim reporting. The Company believes that the disclosures made are adequate to make that information not misleading. These unaudited interim consolidated financial statements should be read in conjunction with the consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 2017 (our “Form 10-K”).

Use of Estimates

The preparation of consolidated financial statements in accordance with GAAP requires us to make estimates and assumptions that affect the amounts reported and disclosed in the consolidated financial statements and the accompanying notes. Actual results could differ materially from these estimates.

Change in Presentation

During the first quarter of 2018, we changed the presentation of certain bundled revenue streams. Such revenue was previously included as part of software delivery, support and maintenance revenue. Under the new presentation, such revenue is included as part of client services revenue. The revenues previously reported for the three and nine months ended September 30, 2017 have been recast to match the new presentation by reducing software delivery, support and maintenance and increasing client services by $5.1 million and $13.6 million, respectively.

Significant Accounting Policies

We adopted Financial Accounting Standards Board (“FASB”) Accounting Standards Update No. 2014-09, Revenue from Contracts with Customers: Topic 606 (“ASC 606”) effective on January 1, 2018 using the modified retrospective method for all contracts not completed as of the date of adoption. There have been no other significant changes to our significant accounting policies from those disclosed in our Form 10-K.

Recently Adopted Accounting Pronouncements

In January 2016, the FASB issued Accounting Standards Update No. 2016-01, “Recognition and Measurement of Financial Assets and Financial Liabilities” (“ASU 2016-01”). The amendments in ASU 2016-01 modify the requirements related to the measurement of certain financial instruments in the statement of financial condition and results of operation. Equity investments (except those accounted for under the equity method of accounting or those that result in consolidation of the investee) are required to be measured at fair value with changes in fair value recognized in net income. An entity may continue to elect to measure equity investments which do not have a readily determinable fair value at cost with adjustments for impairment, if any, and observable changes in price. In addition, for a liability (other than a derivative liability) that an entity measures at fair value, any change in fair value related to the instrument-specific credit risk (i.e., the entity’s own credit risk), should be presented separately in other comprehensive income and not as a component of net income. ASU 2016-01 also clarifies that an entity should evaluate the need for a valuation allowance on a deferred tax asset related to available-for sale securities in combination with the entity’s other deferred tax assets. We adopted ASU 2016-01 effective January 1, 2018 and there was no immediate impact upon adoption. Refer to Note 4, “Fair Value Measurements and Long-term Investments,” for additional information regarding our unconsolidated equity investments.

In January 2017, the FASB issued Accounting Standards Update No. 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business (“ASU 2017-01”). ASU 2017-01 provides new accounting guidance to assist an entity in evaluating when a set of transferred assets and activities is a business. We adopted ASU 2017-01 effective January 1, 2018 and there was no immediate impact upon adoption.

Accounting Pronouncements Not Yet Adopted

In August 2018, the FASB issued Accounting Standards Update No. 2018-15, “Intangibles - Goodwill and Other - Internal-Use Software (Subtopic 350-40)” (“ASU 2018-15”), which discusses customer accounting for implementation costs incurred in a cloud computing arrangement that is a service contract. ASU 2018-15 requires an entity (customer) in a hosting arrangement that is a service contract to follow the guidance in Subtopic 350-40 to determine which implementation costs to capitalize as an asset related to the service contract and which costs to expense. Training costs and certain data conversion costs that cannot be capitalized under Subtopic 350-40 also cannot be capitalized for a hosting arrangement that is a service contract. Costs for implementation activities in the application development state are capitalized depending on the nature of the costs, while costs incurred during preliminary stages are expensed. ASU 2018-15 requires the entity to expense the capitalized implementation costs of a hosting arrangement that is a service contract over the term of the hosting arrangement and apply existing impairment guidance in Subtopic 350-40 to the capitalized implementation costs related to each module or component of a hosting arrangement that is a service contract. ASU 2018-15 also requires the entity to present the expense related to the capitalized implementation costs in the same line item in the statement of operations as the fees associated with the hosting element of the arrangement and classify payments for capitalized implementation costs in the statement of cash flows in the same manner as payments made for fees associated with the hosting element. The entity is required to present the capitalized implementation costs in the balance sheet in the same line item that a prepayment for the hosting arrangement fees would be presented. ASU 2018-15 is effective for interim and annual periods beginning after December 15, 2019. Early adoption is permitted and can be applied either retrospectively or prospectively. We early adopted ASU 2018-15 on a prospective basis effective October 1, 2018 and do not expect any impact upon adoption.

In August 2018, the FASB issued Accounting Standards Update No. 2018-13, “Fair Value Measurement (Topic 820) – Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement” (“ASU 2018-13”), which eliminates, adds and modifies certain disclosure requirements for fair value measurements. Entities will no longer be required to disclose the amount of and reasons for transfers between Level 1 and Level 2 of the fair value hierarchy, but public companies will be required to disclose the range and weighted average used to develop significant unobservable inputs for Level 3 fair value instruments. ASU 2018-13 will be effective for all entities for interim and annual periods beginning after December 15, 2019, with early adoption permitted. We are currently evaluating the impact of this accounting guidance.

In June 2018, the FASB issued Accounting Standards Update No. 2018-07, “Compensation-Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting” (“ASU 2018-07”), which expands the scope of Topic 718 to include share-based payment transactions for acquiring goods and services from nonemployees. ASU 2018-07 specifies that Topic 718 applies to all share-based payment transactions in which a grantor acquires goods or services to be used or consumed in its own operations by issuing share-based payment awards. ASU 2018-07 also clarifies that Topic 718 does not apply to share-based payments used to effectively provide (1) financing to the issuer or (2) awards granted in conjunction with selling goods or services to customers as part of a contract accounted for under ASC 606. ASU 2018-07 is effective for interim and annual periods beginning after December 15, 2018. We are currently evaluating the impact of this accounting guidance.

In February 2016, the FASB issued Accounting Standards Update No. 2016-02, “Leases (Topic 842)” (“ASU 2016-02”), intended to improve financial reporting about leasing transactions. The new guidance will require entities that lease assets to recognize on their balance sheets the assets and liabilities for the rights and obligations created by those leases and to disclose key information about the leasing arrangements. ASU 2016-02 is effective for interim and annual periods beginning after December 15, 2018 with early adoption permitted. We plan to adopt ASU 2016-02 on January 1, 2019 using the cumulative-effect adjustment transition method approved by the FASB in July 2018. We are in the process of implementing changes to our processes and internal controls to meet the new reporting and disclosure requirements. We have implemented a software tool to assist us in the calculation of the amount of additional assets and liabilities to be included on our consolidated balance sheet related to leases currently classified as operating leases with durations greater than twelve months. In addition to existing lease agreements, we are also reviewing service contracts and other agreements to determine if they contain an embedded lease. We continue to evaluate the expected impact of ASU 2016-02 on disclosures, but do not anticipate any material changes to operating results or liquidity as a result of right-of-use assets and corresponding lease liabilities that will be recorded.

In January 2017, the FASB issued Accounting Standards Update No. 2017-04, Intangibles—Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment (“ASU 2017-04”), which provides new accounting guidance to simplify the accounting for goodwill impairment. ASU 2017-04 removes Step Two of the goodwill impairment test, which requires a hypothetical purchase price allocation. Under the new guidance, a goodwill impairment will equal the amount by which a reporting unit’s carrying value exceeds its fair value, not to exceed the carrying amount of goodwill assigned to the reporting unit. All other goodwill impairment guidance will remain largely unchanged. Entities will continue to have the option to perform a qualitative assessment to determine if a quantitative impairment test is necessary. ASU 2017-04 is effective for annual and interim periods in fiscal years beginning after December 15, 2019 with early adoption permitted for any goodwill impairment tests performed after January 1, 2017. The new guidance is to be applied prospectively. We are currently evaluating the impact of this accounting guidance, including the timing of adoption.

In August 2017, the FASB issued Accounting Standards Update No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities (“ASU 2017-12”), which provides new accounting guidance to simplify and improve the reporting of hedging relationships to better portray the economic results of an entity’s risk management activities in its financial statements. In addition to that main objective, the amendments in ASU 2017-12 make certain targeted improvements to simplify the application of the hedge accounting guidance in current GAAP. ASU 2017-12 is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years, with early adoption permitted. We will adopt ASU 2017-02 on January 1, 2019.

We do not believe that any other recently issued, but not yet effective accounting standards, if adopted, would have a material impact on our consolidated financial statements.

Revenue Recognition

Performance Obligation	Revenue Type	Recurring or Non-recurring Nature	Revenue Recognition Pattern	Measure of progress
Support and maintenance ("SMA")	Software delivery, support and maintenance	Recurring	Over time	Output method (time elapsed) – revenue is recognized ratably over the contract term
Software as a service ("SaaS")	Software delivery, support and maintenance	Recurring	Over time	Output method (time elapsed) – revenue is recognized ratably over the contract term
Private cloud hosting	Client services	Recurring	Over time	Output method (time elapsed) – revenue is recognized ratably over the contract term
Client/Education services	Client services	Non-recurring	Over time	Input method (cost to cost) – revenue is recognized proportionally over the service implementation based on hours
Outsourcing services	Client services	Recurring	Over time	Input method (cost to cost) – revenue is recognized proportionally over the outsourcing period
Payerpath (transaction volume)	Software delivery, support and maintenance	Recurring	Over time	Output method ("right-to-invoice" practical expedient) – value transferred to the customer is reflected on invoicing.
Software licenses	Software delivery, support and maintenance	Non-recurring	Point in time	Upon electronic delivery
Hardware	Software delivery, support and maintenance	Non-recurring	Point in time	Upon shipment

Revenue from Contracts with Customers (Tables)

9 Months Ended

Sep. 30, 2018

Revenue Recognized Related To Various Performance Obligations And Elected Accounting Expedients

The breakdown of revenue recognized related based on the origination of performance obligations and elected accounting expedients is presented in the table below:

(In thousands)	Three Months Ended March 31, 2018		Three Months Ended June 30, 2018		Three Months Ended September 30, 2018
Revenue related to deferred revenue balance at beginning of period	$	204,297	$	215,519	$	177,692
Revenue related to new performance obligations satisfied during the period		257,222		244,082		290,145
Revenue recognized under "right-to-invoice" expedient		49,638		62,812		51,587
Reimbursed travel expenses, shipping and other revenue		2,769		3,164		2,855
Total revenue	$	513,926	$	525,577	$	522,279

Summary of Revenue by Type and Nature of Revenue Stream by Reportable Segments

The below tables summarize revenue by type and nature of revenue stream as well as by our reportable segments:

	Three Months Ended September 30,				Nine Months Ended September 30,
(In thousands)	2018		2017		2018		2017
Revenue:
Software delivery, support and maintenance
Recurring revenue	$	285,564	$	230,577	$	873,010	$	682,107
Non-recurring revenue		44,833		58,525		123,559		150,216
Total software delivery, support and maintenance		330,397		289,102		996,569		832,323
Client services
Recurring revenue	$	136,015	$	109,285	$	392,874	$	314,567
Non-recurring revenue		55,867		51,055		172,339		142,118
Total client services		191,882		160,340		565,213		456,685
Total revenue	$	522,279	$	449,442	$	1,561,782	$	1,289,008

Disaggregation of Revenue by Product Line and Segment

	Three Months Ended September 30, 2018
(In thousands)	Clinical and Financial Solutions		Population Health		Netsmart		Unallocated			Discontinued Operations		Total
Software delivery, support and maintenance	$	225,259	$	51,613	$	56,283	$	(2,758	)	$	0	$	330,397
Client services		156,202		8,065		35,799		(8,184	)		0		191,882
Total revenue	$	381,461	$	59,678	$	92,082	$	(10,942	)	$	0	$	522,279

	Three Months Ended September 30, 2017
(In thousands)	Clinical and Financial Solutions		Population Health		Netsmart		Unallocated			Discontinued Operations		Total
Software delivery, support and maintenance	$	192,351	$	40,896	$	52,588	$	3,267		$	0	$	289,102
Client services		127,145		3,627		31,030		(1,462	)		0		160,340
Total revenue	$	319,496	$	44,523	$	83,618	$	1,805		$	0	$	449,442

	Nine Months Ended September 30, 2018
(In thousands)	Clinical and Financial Solutions		Population Health		Netsmart		Unallocated			Discontinued Operations			Total
Software delivery, support and maintenance	$	691,084	$	163,708	$	157,479	$	(3,666	)	$	(12,036	)	$	996,569
Client services		453,853		22,743		103,455		(17,029	)		2,191			565,213
Total revenue	$	1,144,937	$	186,451	$	260,934	$	(20,695	)	$	(9,845	)	$	1,561,782

	Nine Months Ended September 30, 2017
(In thousands)	Clinical and Financial Solutions		Population Health		Netsmart		Unallocated			Discontinued Operations		Total
Software delivery, support and maintenance	$	553,493	$	119,606	$	148,633	$	10,591		$	0	$	832,323
Client services		366,294		10,854		86,413		(6,876	)		0		456,685
Total revenue	$	919,787	$	130,460	$	235,046	$	3,715		$	0	$	1,289,008

ASC 606

Impact of Adoption of ASC 606 on Financial Statements

The table below reflects the cumulative adjustments that were made to balances previously reported in the condensed consolidated balance sheet as of December 31, 2017. During the nine months ended September 30, 2018, we identified additional cumulative adjustments, which resulted in a decrease to Accumulated deficit of $14.8 million, an increase to Accounts receivable, net of $0.6 million, an increase to Contract assets of $13.9 million, an increase to Deferred taxes, net of $5.2 million and a decrease to Deferred revenue, current of $5.5 million.

	As Reported			Adjustments			Adjusted
(In thousands)	December 31, 2017			due to ASC 606			January 1, 2018
Accounts receivable, net	$	567,873		$	(31,948	)	$	535,925
Contract assets		0			90,449			90,449
Prepaid expenses and other current assets		115,463			11,646			127,109

Deferred revenue, current		546,830			(12,901	)		533,929
Deferred revenue, long-term		24,047			0			24,047
Deferred taxes, net		93,643			21,668			115,311
Accumulated deficit		(338,150	)		61,380			(276,770	)

The following tables compare the reported condensed consolidated balance sheet and statement of operations as of and for the three and nine months ended September 30, 2018 to the pro-forma amounts assuming the previous guidance of ASC 605 had been in effect:

	September 30, 2018
(In thousands)	As reported under ASC 606			Adjustments due to ASC 606			Pro forma under ASC 605
Accounts receivable, net	$	520,381		$	52,523		$	572,904
Contract assets		71,745			(71,745	)		0
Prepaid expenses and other current assets		131,826			(13,184	)		118,642
Contract assets - long-term		52,555			(52,555	)		0

Deferred revenue, current		506,568			21,522			528,090
Deferred taxes, net		124,294			(27,816	)		96,478
Accumulated deficit		(251,363	)		(78,667	)		(330,030	)

	Three Months Ended September 30, 2018
(In thousands, except per share amounts)	As reported under ASC 606			Adjustments due to ASC 606			Pro forma under ASC 605
Software delivery, support and maintenance	$	330,397		$	(4,351	)	$	326,046
Client services		191,882			(5,516	)		186,366
Gross profit		218,371			(9,119	)		209,252
Selling, general and administrative expenses		133,214			247			133,461
Income (loss) from operations		2,410			(9,366	)		(6,956	)
Loss from continuing operations before income taxes		(27,635	)		(9,598	)		(37,233	)
Income tax benefit		3,789			2,522			6,311
Net loss		(23,846	)		(7,076	)		(30,922	)
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(35,991	)	$	(7,076	)	$	(43,067	)
Loss per share - basic attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(0.20	)	$	(0.04	)	$	(0.24	)
Loss per share - diluted attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(0.20	)	$	(0.04	)	$	(0.24	)

	Nine Months Ended September 30, 2018
(In thousands, except per share amounts)	As reported under ASC 606			Adjustments due to ASC 606			Pro forma under ASC 605
Software delivery, support and maintenance	$	996,569		$	(15,486	)	$	981,083
Client services		565,213			(7,469	)		557,744
Gross profit		652,009			(22,539	)		629,470
Selling, general and administrative expenses		425,365			140			425,505
Loss from operations		(60,707	)		(22,679	)		(83,386	)
Income (loss) from continuing operations before income taxes		15,160			(23,435	)		(8,275	)
Income tax (provision) benefit		3,020			6,148			9,168
Net income		21,911			(17,287	)		4,624
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(11,041	)	$	(17,287	)	$	(28,328	)
Loss per share - basic attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(0.06	)	$	(0.10	)	$	(0.16	)
Loss per share - diluted attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(0.06	)	$	(0.10	)	$	(0.16	)

Business Combinations (Tables)

9 Months Ended

Sep. 30, 2018

Schedule of Supplemental Proforma Results

(In thousands, except per share amounts)	Three Months Ended September 30, 2017			Nine Months Ended September 30, 2017
Supplemental pro forma data for combined entity:
Revenue	$	551,497		$	1,596,570
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	14,713		$	(195,899	)
Loss per share, basic and diluted	$	(0.08	)	$	(1.08	)

Health Grid [Member]

Schedule of Consideration Funded by Sources of Funds

The consideration paid for Health Grid is shown below:

	(In thousands)
Aggregate purchase price	$	60,000
First earnout payment paid by Allscripts		10,000
Fair value of contingent consideration payment		23,915
Closing purchase price adjustments		2,009
Total consideration paid for Health Grid	$	95,924

Assets Acquired and Liabilities Assumed

	(In thousands)
Cash and cash equivalents	$	1,783
Accounts receivable, net		3,968
Prepaid expenses and other assets		185
Fixed assets		200
Intangible assets		41,000
Goodwill		53,953
Accounts payable and accrued expenses		(478	)
Deferred revenue		(700	)
Long-term deferred tax liability		(3,987	)
Net assets acquired	$	95,924

Acquired Intangible Assets Amortization

The following table summarizes the preliminary fair values of the identifiable intangible assets and their estimated useful lives:

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Customer Relationships	15	$	28,000
Technology	8		13,000
		$	41,000

Practice Fusion, Inc. [Member]

Schedule of Consideration Funded by Sources of Funds

The consideration paid for Practice Fusion is shown below:

	(In thousands)
Aggregate purchase price	$	100,000
Add: Net working capital surplus		373
Add: Closing cash		14,951
Less: Adjustment to assumed indebtedness		(1,684	)
Total consideration paid for Practice Fusion	$	113,640

Assets Acquired and Liabilities Assumed

	(In thousands)
Cash and cash equivalents	$	14,951
Accounts receivable, net		13,328
Prepaid expenses and other current assets		809
Fixed assets		1,764
Intangible assets		67,200
Goodwill		35,234
Other assets		42
Accounts payable and accrued expenses		(7,620	)
Deferred revenue		(2,400	)
Long-term deferred tax liability		(8,853	)
Other liabilities		(815	)
Net assets acquired	$	113,640

Acquired Intangible Assets Amortization

The following table summarizes the fair values of the identifiable intangible assets and their estimated useful lives:

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Customer Relationships - Physician Practices	15	$	28,700
Customer Relationships - Pharmaceutical Partners	20		19,800
Technology	8		14,800
Tradenames	10		3,900
		$	67,200

Barista Operations, LLC [Member]

Assets Acquired and Liabilities Assumed

	(In thousands)
Accounts receivable, net	$	4,470
Contract assets		800
Prepaid expenses and other assets		407
Fixed assets		2,842
Intangible assets		64,000
Goodwill		99,938
Other assets		281
Accounts payable		(1,005	)
Accrued expenses		(764	)
Deferred revenue		(5,838	)
Other liabilities		(300	)
Net assets acquired	$	164,831

Acquired Intangible Assets Amortization

The following table summarizes the fair values of the identifiable intangible assets and their estimated useful lives:

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Customer Relationships	16	$	55,500
Technology	5		8,500
		$	64,000

Fair Value Measurements and Long-term Investments (Tables)

9 Months Ended

Sep. 30, 2018

Fair Value Disclosures [Abstract]

Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis

The following table summarizes our financial assets and liabilities measured at fair value on a recurring basis as of the respective balance sheet dates:

	Balance Sheet	September 30, 2018								December 31, 2017
(In thousands)	Classifications	Level 1		Level 2		Level 3		Total		Level 1		Level 2		Level 3		Total
Foreign exchange derivative assets	Prepaid expenses and other current assets	$	0	$	0	$	0	$	0	$	0	$	1,136	$	0	$	1,136
1.25% Call Option	Other assets		0		0		33,471		33,471		0		0		46,578		46,578
Contingent consideration	Other assets		0		0		3,129		3,129		0		0		2,830		2,830
Total assets		$	0	$	0	$	36,600	$	36,600	$	0	$	1,136	$	49,408	$	50,544

Foreign exchange derivative assets	Other current liabilities	$	0	$	1,560	$	0	$	1,560	$	0	$	0	$	0	$	0
Contingent consideration	Accrued expenses		0		0		12,386		12,386		0		0		2,842		2,842
Contingent consideration	Other liabilities		0		0		16,106		16,106		0		0		5,638		5,638
1.25% Embedded cash conversion option	Other liabilities		0		0		34,907		34,907		0		0		47,777		47,777
Total liabilities		$	0	$	1,560	$	63,399	$	64,959	$	0	$	0	$	56,257	$	56,257

Summary of Changes in Assets and Liabilities Measured at Fair Value on Recurring Basis

The changes in Level 3 assets and liabilities measured at fair value on a recurring basis at September 30, 2018 are summarized as follows:

	(in thousands)
Balance at December 31, 2017	$	6,849
Additions		24,425
Payments		(3,934	)
Fair value adjustments		(541	)
Balance at September 30, 2018	$	26,799

Summary of Long-term Equity Investments Included in Other Assets

The following table summarizes our long-term equity investments which are included in Other assets in the accompanying consolidated balance sheets:

	Number of
	Investees		Original		Carrying Value at
(In thousands, except for number of investees)	at September 30, 2018		Cost		September 30, 2018		December 31, 2017
Equity method investments ⁽¹⁾		8	$	5,658	$	7,788	$	3,258
Cost method investments		4		32,970		14,601		26,755
Total long-term equity investments		12	$	38,628	$	22,389	$	30,013

_________________________________

⁽¹⁾

Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

Stockholders' Equity (Tables)

9 Months Ended

Sep. 30, 2018

Equity [Abstract]

Stock-Based Compensation Expense (Benefit)

	Three Months Ended September 30,				Nine Months Ended September 30,
(In thousands)	2018		2017		2018		2017
Cost of revenue:
Software delivery, support and maintenance	$	498	$	378	$	1,565	$	2,491
Client services		1,103		899		3,679		3,464
Total cost of revenue		1,601		1,277		5,244		5,955
Selling, general and administrative expenses		7,225		7,193		20,934		17,793
Research and development		2,395		1,934		7,362		6,643
Total stock-based compensation expense	$	11,221	$	10,404	$	33,540	$	30,391

Stock-Based Awards Granted

We granted stock-based awards as follows:

	Three Months Ended September 30, 2018				Nine Months Ended September 30, 2018
			Weighted-Average				Weighted-Average
			Grant Date				Grant Date
(In thousands, except per share amounts)	Shares		Fair Value		Shares		Fair Value
Service-based restricted stock units		0	$	0.00		3,468	$	12.87
Performance-based restricted stock units with a service condition		0	$	0.00		524	$	15.74
Market-based restricted stock units with a service condition		0	$	0.00		0	$	0.00
		0	$	0.00		3,992	$	13.25

Earnings (Loss) Per Share (Tables)

9 Months Ended

Sep. 30, 2018

Earnings Per Share [Abstract]

Calculations of Earnings (Loss) Per Share

The calculations of earnings (loss) per share are as follows:

	Three Months Ended September 30,						Nine Months Ended September 30,
(In thousands, except per share amounts)	2018			2017			2018			2017
Basic earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax	$	(23,846	)	$	(17,462	)	$	18,180		$	(169,038	)
Less: Net loss (income) attributable to non-controlling interests		4			(163	)		3,494			(352	)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart		(12,149	)		(10,962	)		(36,446	)		(32,887	)
Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(35,991	)	$	(28,587	)	$	(14,772	)	$	(202,277	)
Net (loss) income from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders		0			0			3,731			0
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(35,991	)	$	(28,587	)	$	(11,041	)	$	(202,277	)

Weighted-average common shares outstanding		174,638			180,634			176,942			180,864

Basic earnings (loss) from continuing operations per Common Share	$	(0.20	)	$	(0.16	)	$	(0.09	)	$	(1.12	)
Basic income from discontinued operations per Common Share		0.00			0.00			0.03			0.00
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(0.20	)	$	(0.16	)	$	(0.06	)	$	(1.12	)

Diluted earnings (loss) per Common Share:
Income (loss) from continuing operations, net of tax	$	(23,846	)	$	(17,462	)	$	18,180		$	(169,038	)
Less: Net loss (income) attributable to non-controlling interests		4			(163	)		3,494			(352	)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - Netsmart		(12,149	)		(10,962	)		(36,446	)		(32,887	)
Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(35,991	)	$	(28,587	)	$	(14,772	)	$	(202,277	)
Net (loss) income from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders		0			0			3,731			0
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(35,991	)	$	(28,587	)	$	(11,041	)	$	(202,277	)

Weighted-average common shares outstanding		174,638			180,634			176,942			180,864
Plus: Dilutive effect of stock options, restricted stock unit awards and warrants		0			0			0			0
Weighted-average common shares outstanding assuming dilution		174,638			180,634			176,942			180,864

Diluted earnings (loss) from continuing operations per Common Share	$	(0.20	)	$	(0.16	)	$	(0.09	)	$	(1.12	)
Diluted income from discontinued operations per Common Share		0.00			0.00			0.03			0.00
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(0.20	)	$	(0.16	)	$	(0.06	)	$	(1.12	)

Anti-Dilutive Stock Options, Restricted Stock Unit Awards and Warrants Excluded from Computation of Diluted Earnings (Loss) Per Share

Three Months Ended

September 30,

Nine Months Ended

September 30,

(In thousands)

2018

2017

2018

2017

Shares subject to anti-dilutive stock options, restricted stock

unit awards and warrants excluded from calculation

24,191

26,085

24,688

26,636

Goodwill and Intangible Assets (Tables)

9 Months Ended

Sep. 30, 2018

Goodwill And Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

Goodwill and intangible assets consist of the following:

	September 30, 2018							December 31, 2017
	Gross							Gross
	Carrying		Accumulated			Intangible		Carrying		Accumulated			Intangible
(In thousands)	Amount		Amortization			Assets, Net		Amount		Amortization			Assets, Net
Intangibles subject to amortization:
Proprietary technology	$	714,983	$	(450,727	)	$	264,256	$	695,354	$	(405,114	)	$	290,240
Customer contracts and relationships		1,030,563		(500,184	)		530,379		922,492		(464,860	)		457,632
Total	$	1,745,546	$	(950,911	)	$	794,635	$	1,617,846	$	(869,974	)	$	747,872

Intangibles not subject to amortization:
Registered trademarks						$	79,000						$	79,000
Goodwill							2,207,967							2,004,953
Total						$	2,286,967						$	2,083,953

Changes in Carrying Amount of Goodwill

Changes in the carrying amounts of goodwill by reportable segment for the nine months ended September 30, 2018 were as follows:

	Clinical and			Population
(In thousands)	Financial Solutions			Health			Netsmart		Total
Balance as of December 31, 2017	$	861,615		$	431,132		$	712,206	$	2,004,953
Additions arising from business acquisitions:
Practice Fusion		35,234			0			0		35,234
Barista Operations, LLC		0			0			99,938		99,938
Health Grid		0			53,953			0		53,953
Other acquisitions		4,492			0			2,522		7,014
Total arising from business acquisitions		39,726			53,953			102,460		196,139
Increases (decreases) due to measurement period adjustments related to prior year acquisitions:
NantHealth provider/patient solutions business		0			117			0		117
Enterprise Information Solutions business		28,182			11,432			0		39,614
Total increases (decreases) due to measurement period adjustments:		28,182			11,549			0		39,731
Total additions to goodwill		67,908			65,502			102,460		235,870
Divestitures		0			(32,306	)		0		(32,306	)
Foreign exchange translation		(550	)		0			0		(550	)
Balance as of September 30, 2018	$	928,973		$	464,328		$	814,666		2,207,967

Debt (Tables)

9 Months Ended

Sep. 30, 2018

Revenue from Contracts with Customers - Additional Information (Detail) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2018 USD ($)	Sep. 30, 2018 USD ($) Revenue_Stream	Sep. 30, 2017 USD ($)	Jan. 01, 2018 USD ($)
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Number of primary revenue streams \| Revenue_Stream		2
Increase in accounts receivable, net		$ (8,051)	$ 31,256
Increase in deferred taxes, net		5,347	5,324
Decrease in deferred revenue, current		(59,595)	$ 18,661
Capitalized Contract Cost Amortization	$ 7,500	23,300
Total backlog	$ 4,700,000	$ 4,700,000
Total backlog, percentage, year one	39.00%	39.00%
Total backlog, percentage after year one	61.00%	61.00%
Perpetual Software License Contracts [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Description of payment terms		The majority of our contracts contain provisions that require customer payment no later than one year from the transfer of control of the related performance obligation.
Interest income recognized	$ 200	$ 700
Selling, General and Administrative Expenses [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost Amortization	7,400	22,900
Cost of revenue [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost Amortization	100	400
Prepaid Expenses and Other Current Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross	26,600	26,600
Other Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross	$ 34,200	$ 34,200
Minimum [Member] \| Perpetual Software License Contracts [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Payments range	2 years	2 years
Maximum [Member] \| Perpetual Software License Contracts [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Payments range	10 years	10 years
ASC 606
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Deferred costs for fulfilment of contract				$ 8,600
ASC 606 \| Minimum [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized cost, amortization period	2 years	2 years
ASC 606 \| Maximum [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized cost, amortization period	9 years	9 years
Adjustments Due to ASC 606 [Member] \| ASC 606
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Decrease in accumulated deficit		$ (14,800)
Increase in accounts receivable, net		600
Increase in contract assets		13,900
Increase in deferred taxes, net		5,200
Decrease in deferred revenue, current		$ (5,500)

Revenue from Contracts with Customers - Impact of Adoption on Previously Reported Condensed Consolidated Balance Sheet (Detail) - USD ($) $ in Thousands	Sep. 30, 2018	Jan. 01, 2018	Dec. 31, 2017
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable, net	$ 520,381		$ 567,873
Contract assets	71,745		0
Prepaid expenses and other current assets	131,826		115,463
Deferred revenue, current	506,568		546,830
Deferred revenue, long-term			24,047
Deferred taxes, net	124,294		93,643
Accumulated deficit	(251,363)		$ (338,150)
ASC 606
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable, net		$ 535,925
Contract assets		90,449
Prepaid expenses and other current assets		127,109
Deferred revenue, current		533,929
Deferred revenue, long-term		24,047
Deferred taxes, net		115,311
Accumulated deficit		(276,770)
ASC 606 \| Adjustments Due to ASC 606 [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable, net	52,523	(31,948)
Contract assets	(71,745)	90,449
Prepaid expenses and other current assets	(13,184)	11,646
Deferred revenue, current	21,522	(12,901)
Deferred revenue, long-term		0
Deferred taxes, net		21,668
Accumulated deficit	$ (78,667)	$ 61,380

Revenue from Contracts with Customers - Schedule of Comparison Between Reported Statements to Pro-forma Amounts in Effect of Previous Guidance - Consolidated Balance Sheet (Detail) - USD ($) $ in Thousands	Sep. 30, 2018	Jan. 01, 2018	Dec. 31, 2017
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Accounts receivable, net	$ 520,381		$ 567,873
Contract assets	71,745		0
Prepaid expenses and other current assets	131,826		115,463
Contract assets - long-term	52,555		0
Deferred revenue, current	506,568		546,830
Deferred taxes, net	124,294
Accumulated deficit	(251,363)		$ (338,150)
ASC 606
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Accounts receivable, net		$ 535,925
Contract assets		90,449
Prepaid expenses and other current assets		127,109
Deferred revenue, current		533,929
Accumulated deficit		(276,770)
ASC 606 \| Adjustments Due to ASC 606 [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Accounts receivable, net	52,523	(31,948)
Contract assets	(71,745)	90,449
Prepaid expenses and other current assets	(13,184)	11,646
Contract assets - long-term	(52,555)
Deferred revenue, current	21,522	(12,901)
Deferred taxes, net	(27,816)
Accumulated deficit	(78,667)	$ 61,380
Pro forma Under ASC 605 [Member] \| ASC 606
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Accounts receivable, net	572,904
Contract assets	0
Prepaid expenses and other current assets	118,642
Contract assets - long-term	0
Deferred revenue, current	528,090
Deferred taxes, net	96,478
Accumulated deficit	$ (330,030)

Revenue from Contract with Customer - Summary of Revenue Recognized Related to Various Performance Obligations and Elected accounting Expedients (Detail) - USD ($) $ in Thousands	3 Months Ended
	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018
Revenue From Contract With Customer [Abstract]
Revenue related to deferred revenue balance at beginning of period	$ 177,692	$ 215,519	$ 204,297
Revenue related to new performance obligations satisfied during the period	290,145	244,082	257,222
Revenue recognized under "right-to-invoice" expedient	51,587	62,812	49,638
Reimbursed travel expenses, shipping and other revenue	2,855	3,164	2,769
Total revenue	$ 522,279	$ 525,577	$ 513,926

Business Combinations - Acquisition of Health Grid - Additional Information (Detail) - USD ($)		3 Months Ended	9 Months Ended
	May 18, 2018	Sep. 30, 2018	Sep. 30, 2018
Business Acquisition [Line Items]
Goodwill expected to be tax deductible	$ 0	$ 0	$ 0
Health Grid [Member]
Business Acquisition [Line Items]
Date of acquisition	May 18, 2018
Purchase price in cash	$ 110,000,000
Purchase price transferred, initial payment	60,000,000
Pre-paid potential earnout payments	10,000,000
Potential earnout payments, fair value	23,915,000
Health Grid [Member] \| Selling, General and Administrative Expenses [Member]
Business Acquisition [Line Items]
Acquisition-related costs		200,000	500,000
Health Grid [Member] \| Level 3 [Member]
Business Acquisition [Line Items]
Potential earnout payments		23,900,000	23,900,000
Potential earnout payments, fair value		$ 23,900,000	$ 23,900,000
Health Grid [Member] \| Maximum [Member]
Business Acquisition [Line Items]
Potential earnout payments	50,000,000
Remaining potential payments	$ 40,000,000

Assets Acquired and Liabilities Assumed (Detail) - USD ($) $ in Thousands	Sep. 30, 2018	Jul. 02, 2018	May 18, 2018	Feb. 13, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Goodwill	$ 2,207,967				$ 2,004,953
Health Grid [Member]
Business Acquisition [Line Items]
Cash and cash equivalents			$ 1,783
Accounts receivable, net			3,968
Prepaid expenses and other assets			185
Fixed assets			200
Intangible assets			41,000
Goodwill			53,953
Accounts payable and accrued expenses			(478)
Deferred revenue			(700)
Long-term deferred tax liability			(3,987)
Net assets acquired			$ 95,924
Practice Fusion, Inc. [Member]
Business Acquisition [Line Items]
Cash and cash equivalents				$ 14,951
Accounts receivable, net				13,328
Prepaid expenses and other assets				809
Fixed assets				1,764
Intangible assets				67,200
Goodwill				35,234
Other assets				42
Accounts payable and accrued expenses				(7,620)
Deferred revenue				(2,400)
Long-term deferred tax liability				(8,853)
Other liabilities				(815)
Net assets acquired				$ 113,640
Barista Operations, LLC [Member]
Business Acquisition [Line Items]
Accounts receivable, net		$ 4,470
Contract assets		800
Prepaid expenses and other assets		407
Fixed assets		2,842
Intangible assets		64,000
Goodwill		99,938
Other assets		281
Accounts payable and accrued expenses		(1,005)
Accrued expenses		(764)
Deferred revenue		(5,838)
Other liabilities		(300)
Net assets acquired		$ 164,831

Business Combinations - Acquisition of Practice Fusion, Inc - Additional Information (Detail) - USD ($)		3 Months Ended	9 Months Ended
	Feb. 13, 2018	Sep. 30, 2018	Sep. 30, 2018	May 18, 2018
Business Acquisition [Line Items]
Goodwill expected to be tax deductible		$ 0	$ 0	$ 0
Practice Fusion, Inc. [Member]
Business Acquisition [Line Items]
Date of acquisition	Feb. 13, 2018
Total consideration paid	$ 113,640,000
Practice Fusion, Inc. [Member] \| Selling, General and Administrative Expenses [Member]
Business Acquisition [Line Items]
Acquisition-related costs		$ 0	$ 800,000

Business Combinations - Acquisition of Barista Operations, LLC - Additional Information (Detail) - Barista Operations, LLC [Member] - USD ($) $ in Millions		9 Months Ended
	Jul. 02, 2018	Sep. 30, 2018
Business Acquisition [Line Items]
Date of acquisition	Jul. 02, 2018
Amortization period of goodwill for tax purposes		15 years
Purchase Agreement [Member]
Business Acquisition [Line Items]
Date of acquisition	Jul. 02, 2018
Total consideration paid	$ 167.5
Escrow deposited	$ 2.5

Business Combinations - Other Acquisitions and Divestiture - Additional Information (Detail) - USD ($)						1 Months Ended	3 Months Ended		9 Months Ended
	Jun. 15, 2018	Apr. 02, 2018	Feb. 06, 2018	Jan. 31, 2018	Oct. 02, 2017	Apr. 30, 2018	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	May 18, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Acquisition of outstanding minority interest in third party	$ 6,900,000
Gain (loss) on sale of business							$ 0	$ 0	$ 172,258,000	$ 0
Equity method investments							7,788,000		7,788,000			$ 3,258,000
Cash paid for business acquisitions									343,873,000	$ 54,308,000
Goodwill							2,207,967,000		2,207,967,000			$ 2,004,953,000
Goodwill expected to be tax deductible							$ 0		$ 0		$ 0
Unit Purchase Agreement [Member]
Business Acquisition [Line Items]
Total consideration paid				$ 5,400,000
Goodwill				$ 2,500,000
Date of acquisition agreement date				Jan. 31, 2018
Consideration paid in cash				$ 2,000,000
Ownership percentage acquired				100.00%
Business combination consideration remaining amount payable				$ 3,600,000
EIS Business [Member]
Business Acquisition [Line Items]
Total consideration paid					$ 185,000,000	$ 2,700,000
Effective date of divestiture									March 15, 2018
Minority interest percentage							35.70%		35.70%
Equity method investments							$ 4,000,000		$ 4,000,000
Initial loss on sale of business									900,000
Additional loss on sale of business									$ 4,700,000
Cloud-based Analytics Software Platform Provider [Member]
Business Acquisition [Line Items]
Date of acquisition			Feb. 06, 2018
Cash paid for business acquisitions			$ 8,000,000
Goodwill			4,800,000
Accounts receivable, net			800,000
Liabilities assumed, account payable			200,000
Liabilities assumed, deferred revenue			600,000
Liabilities assumed, deferred tax liabilities net			1,100,000
Goodwill expected to be tax deductible			0
Cloud-based Analytics Software Platform Provider [Member] \| Technology-Based Intangible Assets
Business Acquisition [Line Items]
Intangible assets			3,700,000
Description									8 years
Cloud-based Analytics Software Platform Provider [Member] \| Customer Relationships
Business Acquisition [Line Items]
Intangible assets			$ 600,000
Description									1 year
One Content Business [Member]
Business Acquisition [Line Items]
Date of divestiture		Apr. 02, 2018
Total consideration paid		$ 260,000,000
Gain (loss) on sale of business									$ 177,900,000

Business Combinations - Acquisition of DeVero - Additional Information (Detail) - USD ($) $ in Thousands		9 Months Ended
	Jul. 17, 2017	Sep. 30, 2018	Sep. 30, 2017
Business Acquisition [Line Items]
Cash paid for business acquisitions		$ 343,873	$ 54,308
Netsmart [Member] \| DeVero Inc [Member]
Business Acquisition [Line Items]
Date of acquisition	Jul. 17, 2017
Cash paid for business acquisitions	$ 50,500

Business Combinations - Acquisition of the Patient/Provider Engagement Solutions Business from NantHealth, Inc. - Additional Information (Detail) $ in Thousands	9 Months Ended
	Sep. 30, 2018 USD ($)
Business Acquisition [Line Items]
Goodwill Purchase Accounting Adjustments	$ 39,731
NantHealth, Inc. [Member]
Business Acquisition [Line Items]
Date of acquisition	Aug. 25, 2017
Goodwill Purchase Accounting Adjustments	$ 117

Business Combinations and Other Investments - Acquisition of the Enterprise Information Solutions Business from McKesson Corporation - Additional Information (Detail) $ in Thousands		1 Months Ended	9 Months Ended
	Oct. 02, 2017 USD ($) Subsidiary	Apr. 30, 2018 USD ($)	Sep. 30, 2018 USD ($)
Business Acquisition [Line Items]
Goodwill Purchase Accounting Adjustments			$ 39,731
EIS Business [Member]
Business Acquisition [Line Items]
Number of wholly owned subsidiaries in which outstanding equity interest acquired \| Subsidiary	2
Total consideration paid	$ 185,000	$ 2,700
Goodwill Purchase Accounting Adjustments			39,614
Increase in deferred revenue			44,000
Decrease in working capital			1,800
Increase in tax liabilities			400
Increases in identified intangible assets			$ 6,600

Business Combinations - Formation of Joint Business Entity and Acquisition of Netsmart, Inc - Additional Information (Detail) - USD ($) $ in Millions		9 Months Ended
	Apr. 19, 2016	Sep. 30, 2018
Business Acquisition [Line Items]
Contribution and investment agreement date		Mar. 20, 2016
Homecare Business [Member]
Business Acquisition [Line Items]
Escrow deposit related to the integration of homecare business	$ 15.0	$ 7.0
Escrow deposit period	5 years
Netsmart [Member]
Business Acquisition [Line Items]
Netsmart transaction completion date		Apr. 19, 2016

Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	$ 131,826	$ 115,463
Total assets	36,600	50,544
Total liabilities	64,959	56,257
Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	0	1,136
Other current liabilities	1,560	0
Contingent Consideration [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	3,129	2,830
Accrued expenses	12,386	2,842
Other liabilities	16,106	5,638
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	34,907	47,777
1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	33,471	46,578
Level 1 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets	0	0
Total liabilities	0	0
Level 1 [Member] \| Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	0	0
Other current liabilities	0	0
Level 1 [Member] \| Contingent Consideration [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	0	0
Accrued expenses	0	0
Other liabilities	0	0
Level 1 [Member] \| 1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	0	0
Level 1 [Member] \| 1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	0	0
Level 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets	0	1,136
Total liabilities	1,560	0
Level 2 [Member] \| Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	0	1,136
Other current liabilities	1,560	0
Level 2 [Member] \| Contingent Consideration [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	0	0
Accrued expenses	0	0
Other liabilities	0	0
Level 2 [Member] \| 1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	0	0
Level 2 [Member] \| 1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	0	0
Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets	36,600	49,408
Total liabilities	63,399	56,257
Level 3 [Member] \| Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	0	0
Other current liabilities	0	0
Level 3 [Member] \| Contingent Consideration [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	3,129	2,830
Accrued expenses	12,386	2,842
Other liabilities	16,106	5,638
Level 3 [Member] \| 1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	34,907	47,777
Level 3 [Member] \| 1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	$ 33,471	$ 46,578

Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Parenthetical) (Detail)	Sep. 30, 2018
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Interest rate	1.25%
1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Interest rate	1.25%

Summary of Changes in Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) $ in Thousands	9 Months Ended
	Sep. 30, 2018 USD ($)
Fair Value, Net Derivative Asset (Liability) and Contingent Consideration Measured on Recurring Basis, Unobservable Input Reconciliation [Roll Forward]
Balance at December 31, 2017	$ 6,849
Additions	24,425
Payments	(3,934)
Fair value adjustments	(541)
Balance at September 30, 2018	$ 26,799

Stock-Based Awards Granted (Detail) - $ / shares shares in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2018
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, granted	0	3,992
Weighted-Average Grant Date Fair Value, granted	$ 0.00	$ 13.25
Service-Based Restricted Stock Units [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, granted	0	3,468
Weighted-Average Grant Date Fair Value, granted	$ 0.00	$ 12.87
Performance-Based Restricted Stock Units with a Service Condition [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, granted	0	524
Weighted-Average Grant Date Fair Value, granted	$ 0.00	$ 15.74
Market-Based Restricted Stock Units with a Service Condition [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, granted	0	0
Weighted-Average Grant Date Fair Value, granted	$ 0.00	$ 0.00

Goodwill and Intangible Assets (Detail) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	$ 1,745,546	$ 1,617,846
Accumulated Amortization	(950,911)	(869,974)
Intangible Assets, Net	794,635	747,872
Registered trademarks	79,000	79,000
Goodwill	2,207,967	2,004,953
Total	2,286,967	2,083,953
Proprietary Technology [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	714,983	695,354
Accumulated Amortization	(450,727)	(405,114)
Intangible Assets, Net	264,256	290,240
Customer Contracts and Relationships [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	1,030,563	922,492
Accumulated Amortization	(500,184)	(464,860)
Intangible Assets, Net	$ 530,379	$ 457,632

Changes in Carrying Amount of Goodwill (Detail) $ in Thousands	9 Months Ended
	Sep. 30, 2018 USD ($)
Goodwill [Line Items]
Goodwill	$ 2,004,953
Additions arising from business acquisitions	196,139
Total increases (decreases) due to measurement period adjustments:	39,731
Total additions to goodwill	235,870
Divestitures	(32,306)
Foreign exchange translation	(550)
Goodwill, net	2,207,967
Practice Fusion, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	35,234
Barista Operations, LLC [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	99,938
Health Grid [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	53,953
Other [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	7,014
NantHealth, Inc. [Member]
Goodwill [Line Items]
Total increases (decreases) due to measurement period adjustments:	117
EIS Business [Member]
Goodwill [Line Items]
Total increases (decreases) due to measurement period adjustments:	39,614
Clinical and Financial Solutions [Member]
Goodwill [Line Items]
Goodwill	861,615
Additions arising from business acquisitions	39,726
Total increases (decreases) due to measurement period adjustments:	28,182
Total additions to goodwill	67,908
Divestitures	0
Foreign exchange translation	(550)
Goodwill, net	928,973
Clinical and Financial Solutions [Member] \| Practice Fusion, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	35,234
Clinical and Financial Solutions [Member] \| Barista Operations, LLC [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	0
Clinical and Financial Solutions [Member] \| Health Grid [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	0
Clinical and Financial Solutions [Member] \| Other [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	4,492
Clinical and Financial Solutions [Member] \| NantHealth, Inc. [Member]
Goodwill [Line Items]
Total increases (decreases) due to measurement period adjustments:	0
Clinical and Financial Solutions [Member] \| EIS Business [Member]
Goodwill [Line Items]
Total increases (decreases) due to measurement period adjustments:	28,182
Population Health [Member]
Goodwill [Line Items]
Goodwill	431,132
Additions arising from business acquisitions	53,953
Total increases (decreases) due to measurement period adjustments:	11,549
Total additions to goodwill	65,502
Divestitures	(32,306)
Foreign exchange translation	0
Goodwill, net	464,328
Population Health [Member] \| Practice Fusion, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	0
Population Health [Member] \| Barista Operations, LLC [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	0
Population Health [Member] \| Health Grid [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	53,953
Population Health [Member] \| Other [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	0
Population Health [Member] \| NantHealth, Inc. [Member]
Goodwill [Line Items]
Total increases (decreases) due to measurement period adjustments:	117
Population Health [Member] \| EIS Business [Member]
Goodwill [Line Items]
Total increases (decreases) due to measurement period adjustments:	11,432
Netsmart [Member]
Goodwill [Line Items]
Goodwill	712,206
Additions arising from business acquisitions	102,460
Total increases (decreases) due to measurement period adjustments:	0
Total additions to goodwill	102,460
Divestitures	0
Foreign exchange translation	0
Goodwill, net	814,666
Netsmart [Member] \| Practice Fusion, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	0
Netsmart [Member] \| Barista Operations, LLC [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	99,938
Netsmart [Member] \| Health Grid [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	0
Netsmart [Member] \| Other [Member]
Goodwill [Line Items]
Additions arising from business acquisitions	2,522
Netsmart [Member] \| NantHealth, Inc. [Member]
Goodwill [Line Items]
Total increases (decreases) due to measurement period adjustments:	0
Netsmart [Member] \| EIS Business [Member]
Goodwill [Line Items]
Total increases (decreases) due to measurement period adjustments:	$ 0

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($)			9 Months Ended
	Jul. 02, 2018	Jan. 02, 2018	Sep. 30, 2018	Jul. 01, 2018	Mar. 31, 2018	Feb. 06, 2018	Jan. 01, 2018	Dec. 31, 2017
Schedule Of Goodwill And Intangible Assets [Line Items]
Accumulated impairment losses associated with goodwill			$ 0					$ 0
Additions			196,139,000
Goodwill reduction due to divestiture			32,306,000
Goodwill, impairments recorded	$ 0	$ 0
Goodwill			2,207,967,000					$ 2,004,953,000
Hospital and Health Systems [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Percentage of excess of fair value over carrying value				10.00%			10.00%
Goodwill					$ 511,200,000
EIS Business [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill reduction due to divestiture			2,200,000
One Content Business [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill reduction due to divestiture			30,100,000
Cloud-based Analytics Software Platform Provider [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Additions			4,500,000
Goodwill						$ 4,800,000
Provider of Billing Solutions [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Additions			$ 2,500,000

Summary of Future Debt Payment Obligations (Parenthetical) (Detail)	9 Months Ended
	Sep. 30, 2018
1.25% Cash Convertible Senior Notes [Member]
Debt Instrument [Line Items]
Maturity date	Jul. 01, 2020

Effective Tax Rates (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
Effective Tax Rates (Detail) - USD ($) $ in Thousands	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Income Tax Disclosure [Abstract]
(Loss) income from continuing operations before income taxes	$ (27,635)	$ (17,700)	$ 15,160	$ (170,111)
Income tax benefit	$ 3,789	$ 238	$ 3,020	$ 1,073
Effective tax rate	13.70%	1.30%	(19.90%)	0.60%

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	9 Months Ended	12 Months Ended
	Sep. 30, 2018	Dec. 31, 2017
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Statutory tax rate	21.00%	35.00%
Provisional income tax benefit		$ 20.8
Tax benefit resulting from remeasurement deferred tax balance		26.0
Tax expense on accumulated foreign subsidiary earnings resulted from reduced federal rate		5.2
Cumulative operating income loss period considered	3 years
Unrecognized income tax benefits	$ 12.6	$ 12.0
Valuation Allowance of Deferred Tax Assets [Member]
Income Loss From Operations Before Provision Benefit For Income Taxes [Line Items]
Utilization of capital loss carryforward against capital gain	$ 14.4

Fair Value and Balance Sheet Locations - (Detail) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Derivatives Fair Value [Line Items]
Derivative asset, fair value	$ 33,471	$ 47,714
Derivative liability, fair value	36,467	47,777
Designated as Hedging Instrument [Member] \| Foreign Exchange Contract [Member] \| Prepaid Expenses and Other Current Assets [Member]
Derivatives Fair Value [Line Items]
Derivative asset, fair value	0	1,136
Designated as Hedging Instrument [Member] \| Foreign Exchange Contract [Member] \| Accrued expenses [Member]
Derivatives Fair Value [Line Items]
Derivative liability, fair value	1,560	0
Not Designated as Hedging Instrument [Member] \| 1.25% Call Option [Member] \| Other Assets [Member]
Derivatives Fair Value [Line Items]
Derivative asset, fair value	33,471	46,578
Not Designated as Hedging Instrument [Member] \| 1.25% Embedded Cash Conversion Option [Member] \| Other Liabilities [Member]
Derivatives Fair Value [Line Items]
Derivative liability, fair value	$ 34,907	$ 47,777

Derivative Financial Instruments - Additional Information (Detail)	3 Months Ended	9 Months Ended
	Sep. 30, 2018 USD ($) Derivative	Sep. 30, 2018 USD ($) Derivative	Sep. 30, 2018 INR (₨) Derivative	Jun. 18, 2013 USD ($)
1.25% Call Option [Member]
Derivative [Line Items]
Debt instrument interest rate	1.25%	1.25%	1.25%
Foreign Exchange Forward Contracts [Member]
Derivative [Line Items]
Number of contracts \| Derivative	15	15	15
Amount of Gain (Loss) Recognized in AOCI (Effective Portion)	$ 0	$ 0
Amount of Gain (Loss) Reclassified from AOCI into Income (Effective Portion)	0	0
Unrealized derivatives gains (losses) included in other comprehensive (loss) income reclassified into income	(1,600,000)	$ (1,600,000)
Estimated period of unrealized losses included in AOCI reclassified into income		12 months
Foreign Exchange Forward Contracts [Member] \| Minimum [Member]
Derivative [Line Items]
Date of contracts mature		Oct. 31, 2018
Derivative notional amount outstanding	2,200,000	$ 2,200,000	₨ 160,000,000
Foreign Exchange Forward Contracts [Member] \| Maximum [Member]
Derivative [Line Items]
Date of contracts mature		Dec. 31, 2019
Derivative notional amount outstanding	$ 2,600,000	$ 2,600,000	₨ 190,000,000
1.25% Notes Embedded Cash Conversion Option [Member]
Derivative [Line Items]
Debt instrument interest rate	1.25%	1.25%	1.25%
1.25% Notes Embedded Cash Conversion Option [Member] \| Level 3 [Member] \| Fair Value Measurements, Recurring [Member]
Derivative [Line Items]
Fair value liability of embedded cash conversion option				$ 82,800,000

Components of Accumulated Other Comprehensive Loss (Parenthetical) (Detail) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017	Sep. 30, 2017	Dec. 31, 2016
Unrealized Net Gains (Losses) on Available for Sale Securities [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized net gains (losses), taxes (benefits)			$ 58	$ 61
Foreign Exchange Contract [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized net gains (losses), taxes (benefits)	$ (405)	$ 445	$ 531	$ 402

Contingencies - Additional Information (Detail)	May 01, 2012 USD ($)
Commitments And Contingencies Disclosure [Abstract]
Plaintiff sought amount for each alleged violation	$ 500

Discontinued Operations - Additional Information (Detail)	3 Months Ended	6 Months Ended	9 Months Ended
	Sep. 30, 2018 USD ($)	Sep. 30, 2018 Offering	Sep. 30, 2018 USD ($)
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Cash used from discontinued operations	$ 2,200,000		$ 3,400,000
EIS Business [Member]
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items]
Number of product offerings acquired \| Offering		2
Gain (Loss) on disposal of discontinued operations before tax	$ 0		$ 0

Summary of Major Classes of Assets and Liabilities of Discontinued Operations (Detail) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Carrying amounts of major classes of assets included as part of discontinued operations:
Total assets attributable to discontinued operations	$ 0	$ 11,276
Carrying amounts of major classes of liabilities included as part of discontinued operations:
Total liabilities attributable to discontinued operations	2,261	21,358
Horizon Clinicals and Series2000 [Member]
Carrying amounts of major classes of assets included as part of discontinued operations:
Accounts receivable, net	0	8,196
Prepaid expenses and other current assets	0	3,080
Total assets attributable to discontinued operations	0	11,276
Carrying amounts of major classes of liabilities included as part of discontinued operations:
Accounts payable	0	114
Accrued expenses	2,261	5,599
Accrued compensation and benefits	0	7,728
Deferred revenue	0	7,241
Other classes of liabilities that are not major	0	676
Total liabilities attributable to discontinued operations	$ 2,261	$ 21,358

Business Segments - Additional Information (Detail)	3 Months Ended	9 Months Ended
Business Segments - Additional Information (Detail)	Sep. 30, 2017 USD ($)	Sep. 30, 2018 Segment	Sep. 30, 2017 USD ($)
Segment Reporting Information [Line Items]
Number of reportable segments \| Segment		3
Number of operating segments \| Segment		10
Population Health [Member]
Segment Reporting Information [Line Items]
Number of operating segments \| Segment		5
Increase in gross profit	$ 0		$ 0
Increase in operating income loss	1,000,000		1,000,000
Clinical and Financial Solutions [Member]
Segment Reporting Information [Line Items]
Increase in gross profit	0		2,000,000
Increase in operating income loss	$ 12,000,000		$ 33,000,000