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Organization Consolidation And Presentation Of Financial Statements [Abstract]

Business Segments

17. 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, which was part of our Population Health reportable segment, into several components. The dbMotion business unit, previously included in the Population Health operating segment, was 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, previously included in the Population Health operating segment, were combined into a new Careport operating segment within the Population Health reportable segment. In addition, the 2bPrecise business became a separate operating segment. The segment disclosures below for the years ended December 31, 2017 and 2016, were have been 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. 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 our reportable segments for the years ended December 31, 2017 and 2016 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 $3 million and $38 million, respectively, for the year ended December 31, 2017 and by $2 million and $44 million, respectively, for the year ended December 31, 2016. In addition, the gross profit and income from operations of the Population Health reportable segment increased by nil and $1 million, respectively, for the year ended December 31, 2017 and increased by nil and $2 million, respectively, for the year ended December 31, 2016.

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, previously part of the Veradigm operating segment (f/k/a Payor and Life Sciences operating segment), to the Ambulatory operating segment. This transfer had no impact on our reportable segments since both the Ambulatory and Veradigm operating segments are included within the Clinical and Financial Solutions reportable segment.

During the fourth quarter of 2018, we further streamlined the Company’s operating segments. We merged the leadership and remaining businesses of the EIS-EWS operating segment with the EIS-Classics operating segment. This change was primarily driven by the sale of the Strategic Sourcing and OneContent business units earlier in 2018, which together comprised a substantial majority of the EIS-EWS operating segment. Refer to Note 3, “Business Combinations and Other Investments” for additional information regarding the sale of the Strategic Sourcing and OneContent business units. We also merged the leadership and assets of the NantHealth operating segment with the Hospitals and Health Systems operating segment. The EIS-EWS and NantHealth operating segments were previously included in the Population Health reportable segment, while the EIS-Classics and Hospitals and Health Systems operating segments are included within the Clinical and Financial Solutions reportable segment. The segment disclosures below for the years ended December 31, 2017 and 2016, have been revised to conform to the current year presentation.

Finally, on December 31, 2018, we sold all of our investment in Netsmart. Prior to the sale, Netsmart comprised a separate reportable segment, which due to its significance to our historical consolidated financial statements and results of operations, is reported as a discontinued operation as a result of the sale. In addition, the results of operations related to two of the product offerings acquired with the EIS Business (Horizon Clinicals and Series2000) are also presented throughout these financial statements as discontinued operations and are included within the Clinical and Financial Solutions reportable segment, except for acquisition-related deferred revenue adjustments, which are included in “Unallocated Amounts”. Refer to Note 16, “Discontinued Operations.”

As a result of the above changes, as of December 31, 2018, we had eight operating segments, which are aggregated into two reportable segments. The Clinical and Financial Solutions reportable segment includes the Hospitals and Health Systems, Ambulatory, Veradigm, 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 three separate operating segments: Careport, FollowMyHealth^®, and EPSi^TM. 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”). The 2bPrecise operating segment is included in “Unallocated Amounts” based on materiality.

Our Chief Operating Decision Maker (“CODM”) uses segment revenues, gross profit and income from operations as measures of performance and to make decisions about the allocation of resources. 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 revenue acquired in a business combination. 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, (ii) revenue and the associated cost from the resale of certain ancillary products, primarily hardware and (iii) the results of the 2bPrecise operating segment. We do not track our assets by segment.

	Year Ended December 31,
(In thousands)	2018			2017			2016
Revenue:
Clinical and Financial Solutions	$	1,565,987		$	1,337,030		$	1,183,196
Population Health		190,706			173,809			177,394
Unallocated Amounts		(6,731	)		(13,131	)		25,479
Total revenue	$	1,749,962		$	1,497,708		$	1,386,069

Gross Profit:
Clinical and Financial Solutions	$	663,005		$	574,386		$	496,595
Population Health		146,614			142,514			149,338
Unallocated Amounts		(85,076	)		(84,101	)		(44,634	)
Total gross profit	$	724,543		$	632,799		$	601,299

Income (loss) from operations:
Clinical and Financial Solutions	$	344,568		$	335,005		$	287,077
Population Health		100,118			112,577			123,685
Unallocated Amounts		(537,738	)		(435,098	)		(343,052	)
Total income (loss) from operations	$	(93,052	)	$	12,484		$	67,710

Supplemental Disclosures

12 Months Ended

Dec. 31, 2018

Supplemental Disclosures

18. Supplemental Disclosures

The majority of the restricted cash balance as of December 31, 2018 represents the remaining balance of the escrow account established as part of the acquisition of Netsmart in 2016 to be used by Netsmart to facilitate the integration of our Homecare^TM business within Netsmart and an escrow fund related to a previous acquisition associated with the acquired EIS Business.

	December 31,
(In thousands)	2018		2017
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents	$	174,243	$	119,470
Restricted cash		10,552		11,524
Total cash, cash equivalents and restricted cash	$	184,795	$	130,994

	Year Ended December 31,
(In thousands)	2018		2017		2016
Cash paid during the period for:
Interest	$	28,888	$	21,183	$	14,989
Income taxes paid, net of tax refunds	$	10,108	$	6,675	$	5,466
Non-cash transactions:
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations	$	48,594	$	43,850	$	28,536
Exchange of NantHealth, Inc. common stock for net assets acquired of NantHealth provider/patient engagement solutions business including value assigned to commercial agreement	$	0	$	42,750	$	0
Obligations incurred to purchase capitalized software or enter into capital leases	$	1,501	$	1,897	$	27,127
Contribution of assets in exchange for equity interest	$	4,000	$	0	$	0
Issuance of treasury stock to commercial partner	$	1,121	$	334	$	0

Accrued expenses consist of the following:

	December 31,		December 31,
(In thousands)	2018		2017
Royalties, certain third-party product costs and licenses	$	26,371	$	14,195
Other		79,701		63,605
Total accrued expenses	$	106,072	$	77,800

Other consists of various accrued expenses and no individual item accounted for more than 5% of the current liabilities balance at the respective balance sheet dates.

Other assets consist of the following:

	December 31,		December 31,
(In thousands)	2018		2017
Reseller agreement with Nant Health, LLC	$	0	$	22,252
Fair value of 1.25% Call Option		9,104		46,578
Long-term deferred hosting fees		20,805		0
Long-term prepaid commissions		32,660		32,938
Investments in non-marketable securities		37,040		30,013
Long-term deposits and other assets		9,597		15,070
Total other assets	$	109,206	$	146,851

Geographic Information

12 Months Ended

Dec. 31, 2018

Commitments And Contingencies Disclosure [Abstract]

Geographic Information

19. Geographic Information

Revenues are attributed to geographic regions based on the location where the sale originated. Our revenues by geographic area are summarized below:

	Year Ended December 31,
(In thousands)	2018		2017		2016
United States	$	1,697,178	$	1,440,842	$	1,336,799
Canada		15,377		15,818		18,694
Other international		37,407		41,048		30,576
Total	$	1,749,962	$	1,497,708	$	1,386,069

A summary of our long-lived assets, comprised of fixed assets by geographic area, is presented below:

	December 31,		December 31,
(In thousands)	2018		2017
United States	$	111,836	$	129,021
India		4,231		4,154
Israel		3,830		1,322
Canada		60		146
Other international		1,956		774
Total	$	121,913	$	135,417

Contingencies

12 Months Ended

Dec. 31, 2018

Contingencies

20. 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. Between April 2018 and January 2019, Practice Fusion received five additional requests for documents and information through additional CIDs and Health Insurance Portability and Accountability Act subpoenas. These requests 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. Practice Fusion has produced documents in response to these requests. 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.

Quarterly Financial Information (Unaudited)

12 Months Ended

Dec. 31, 2018

Quarterly Financial Information Disclosure [Abstract]

Quarterly Financial Information (Unaudited)

21. Quarterly Financial Information (Unaudited)

The following tables contain a summary of our unaudited quarterly consolidated results of operations for our last eight fiscal quarters, which have been restated to illustrate Netsmart as a discontinued operation.

	Quarter Ended
	December 31,			September 30,			June 30,			March 31,
(In thousands, except per share amounts)	2018			2018			2018 ⁽¹⁾			2018 ⁽¹⁾
Revenue	$	442,346		$	432,430		$	441,464		$	433,722
Cost of revenue		254,187			254,478			267,697			249,057
Gross profit		188,159			177,952			173,767			184,665
Selling, general and administrative expenses		99,992			108,125			122,913			119,937
Research and development		66,096			63,032			74,491			64,790
Asset impairment charges		28,091			0			30,075			0
Goodwill impairment charge		13,466			0			0			0
Amortization of intangible and acquisition-related assets		6,957			6,609			6,382			6,639
(Loss) income from operations		(26,443	)		186			(60,094	)		(6,701	)
Interest expense		(13,989	)		(13,251	)		(11,979	)		(11,695	)
Other income (loss), net		658			(536	)		(14	)		(34	)
Gain on sale of businesses, net		0			0			173,129			(871	)
Impairment of and losses on long-term investments		0			0			(9,987	)		(5,500	)
Equity in net (loss) income of unconsolidated investments		(270	)		(177	)		767			(61	)
(Loss) income from continuing operations before income taxes		(40,044	)		(13,778	)		91,822			(24,862	)
Income tax benefit (provision)		5,449			1,637			(7,256	)		(299	)
(Loss) income from continuing operations, net of tax		(34,595	)		(12,141	)		84,566			(25,161	)
Loss from discontinued operations		(39,854	)		(13,857	)		(14,109	)		(5,016	)
Gain on sale of Netsmart		500,471			0			0			0
Income tax effect on discontinued operations		(40,126	)		2,152			3,815			1,662
Income (loss) from discontinued operations, net of tax		420,491			(11,705	)		(10,294	)		(3,354	)
Net income (loss)		385,896			(23,846	)		74,272			(28,515	)
Less: Net loss attributable to non-controlling interest		1,033			4			2,700			790
Less: Accretion redemption preference on redeemable non-controlling interest - discontinued operations		(12,148	)		(12,149	)		(12,148	)		(12,149	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	374,781		$	(35,991	)	$	64,824		$	(39,874	)

Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share:
Basic
Continuing operations	$	(0.19	)	$	(0.07	)	$	0.49		$	(0.14	)
Discontinued operations	$	2.36		$	(0.13	)	$	(0.13	)	$	(0.08	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$	2.17		$	(0.20	)	$	0.36		$	(0.22	)

Diluted
Continuing operations	$	(0.19	)	$	(0.07	)	$	0.49		$	(0.14	)
Discontinued operations	$	2.33		$	(0.13	)	$	(0.13	)	$	(0.08	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$	2.14		$	(0.20	)	$	0.36		$	(0.22	)

	Quarter Ended
	December 31,				September 30,			June 30,			March 31,
(In thousands, except per share amounts)	2017 ⁽²⁾				2017 ⁽²⁾			2017			2017
Revenue	$	436,411			$	368,091		$	350,150		$	343,056
Cost of revenue		260,208				205,843			199,930			198,928
Gross profit		176,203				162,248			150,220			144,128
Selling, general and administrative expenses		123,113				93,790			91,033			92,752
Research and development		68,344				46,485			42,205			45,248
Amortization of intangible and acquisition-related assets		6,005				3,816			3,745			3,779
Income from operations		(21,259	)			18,157			13,237			2,349
Interest expense		(11,594	)			(9,251	)		(8,279	)		(8,416	)
Other income (loss), net		160				(685	)		(222	)		235
Impairment of and losses on long-term investments		0				(20,700	)		(144,590	)		0
Equity in net loss of unconsolidated investments		115				449			(28	)		285
Loss from continuing operations before income taxes		(32,578	)			(12,030	)		(139,882	)		(5,547	)
Income tax benefit (provision)		9,973		⁽³⁾		(1,962	)		(1,263	)		(1,234	)
Loss from continuing operations, net of tax		(22,605	)			(13,992	)		(141,145	)		(6,781	)
Income from discontinued operations, net of tax		37,468				(3,470	)		(1,866	)		(1,784	)
Net income (loss)		14,863				(17,462	)		(143,011	)		(8,565	)
Less: Net loss (income) attributable to non-controlling interest		1,918				(163	)		264			(453	)
Less: Accretion redemption preference on redeemable non-controlling interest - discontinued operations		(10,963	)			(10,962	)		(10,963	)		(10,962	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	5,818			$	(28,587	)	$	(153,710	)	$	(19,980	)

Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share:
Basic
Continuing operations	$	(0.12	)		$	(0.08	)	$	(0.78	)	$	(0.04	)
Discontinued operations	$	0.15			$	(0.08	)	$	(0.07	)	$	(0.07	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$	0.03			$	(0.16	)	$	(0.85	)	$	(0.11	)

Diluted
Continuing operations	$	(0.12	)		$	(0.08	)	$	(0.78	)	$	(0.04	)
Discontinued operations	$	0.15			$	(0.08	)	$	(0.07	)	$	(0.07	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$	0.03			$	(0.16	)	$	(0.85	)	$	(0.11	)

⁽¹⁾	Results of operations for the quarter include the results of operations of (i) Practice Fusion since February 13, 2018 and (ii) Health Grid since May 18, 2018.

⁽²⁾	Results of operations for the quarter include the results of operations of (i) the provider/ patient engagement solutions business of NantHealth, Inc. since August 25, 2017 and (ii) the EIS Business since October 2, 2017.

⁽³⁾	Income tax benefit (provision) for the quarter ended December 31, 2017, reflects the estimated impact of the United States Tax Cuts and Jobs Act which was enacted on December 22, 2017 and introduced significant changes to the income tax law in the United States.

Subsequent Events	12 Months Ended
Subsequent Events	Dec. 31, 2018
Subsequent Events [Abstract]
Subsequent Events	Error extracting Word content

Schedule II-Valuation and Qualifying Accounts

12 Months Ended

Dec. 31, 2018

Valuation And Qualifying Accounts [Abstract]

Schedule II-Valuation and Qualifying Accounts

Schedule II—Valuation and Qualifying Accounts

			Charged to
	Balance at		Expenses/		Deferred		Write-Offs,			Balance at
	Beginning of		Against		Revenue		Net of			End of
(In thousands)	Year		Revenue		Reclassification		Recoveries			Year
Allowance for doubtful accounts and sales credits
Year ended December 31, 2018	$	31,386	$	21,156	$	5,512	$	(7,648	)	$	50,406
Year ended December 31, 2017		28,655		7,384		1,482		(6,135	)		31,386
Year ended December 31, 2016		31,266		6,979		661		(10,251	)		28,655

All other schedules are omitted, since the required information is not applicable or is not present in amounts sufficient to require submission of the schedule, or because the information required is included in the consolidated financial statements and notes thereto.

Basis of Presentation and Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Principles of Consolidation

Use of Estimates

Change in Presentation

	Quarter ended												Year ended
(In thousands)	March 31, 2018			June 30, 2018			September 30, 2018			December 31, 2018			December 31, 2018
Cost of revenue reclassification:
Software delivery, support and maintenance	$	(4,033	)	$	(7,202	)	$	(6,394	)	$	(6,400	)	$	(24,029	)
Client services		4,033			7,202			6,394			6,400			24,029
Amortization of software development and acquisition-related assets		0			0			0			0			0
Total cost of revenue:		0			0			0			0			0

Gross profit impact:
Software delivery, support and maintenance		(4,033	)		(7,202	)		(6,394	)		(6,400	)		(24,029	)
Client services		4,033			7,202			6,394			6,400			24,029
Total gross profit	$	0		$	0		$	0		$	0		$	0

The following table illustrates the recast for revenue and associated cost of revenue for the quarterly periods and the year ended December 31, 2017:

	Quarter ended												Year ended
(In thousands)	March 31, 2017			June 30, 2017			September 30, 2017			December 31, 2017			December 31, 2017
Revenue reclassification:
Software delivery, support and maintenance	$	(4,270	)	$	(4,239	)	$	(5,119	)	$	(4,703	)	$	(18,331	)
Client services		4,270			4,239			5,119			4,703			18,331
Total revenue		0			0			0			0			0

Cost of revenue reclassification:
Software delivery, support and maintenance		(5,056	)		(5,556	)		(5,454	)		(5,454	)		(21,520	)
Client services		5,056			5,556			5,454			5,454			21,520
Amortization of software development and acquisition-related assets		0			0			0			0			0
Total cost of revenue:		0			0			0			0			0

Gross profit impact:
Software delivery, support and maintenance		786			1,317			335			751			3,189
Client services		(786	)		(1,317	)		(335	)		(751	)		(3,189	)
Total gross profit	$	0		$	0		$	0		$	0		$	0

The following table illustrates the recast of revenue and associated cost of revenue for the year ended December 31, 2016:

	Year ended
(In thousands)	December 31, 2016
Revenue reclassification:
Software delivery, support and maintenance	$	(8,734	)
Client services		8,734
Total revenue		0

Cost of revenue reclassification:
Software delivery, support and maintenance		(17,831	)
Client services		17,831
Amortization of software development and acquisition-related assets		0
Total cost of revenue:		0

Gross profit impact:
Software delivery, support and maintenance		9,097
Client services		(9,097	)
Total gross profit	$	0

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

Cash and Cash Equivalents

Other Financial Assets and Liabilities

Derivative Financial Instruments

Allowance for Doubtful Accounts Receivable

Contingent Liabilities

Fixed Assets

Business Combinations

Goodwill and Intangible Assets

Long-Lived Assets and Long-Lived Assets to Be Disposed Of

Software Development Costs

The unamortized balances of capitalized software were as follows:

	December 31,
(In thousands)	2018			2017
Software development costs	$	317,637		$	280,146
Less: accumulated amortization		(107,977	)		(85,301	)
Software development costs, net	$	209,660		$	194,845

	Year Ended December 31,
(In thousands)	2018		2017		2016
Capitalized software development costs	$	113,308	$	94,740	$	115,710
Write-offs and divestitures of capitalized software development costs	$	34,083	$	0	$	4,625
Amortization of capitalized software development costs	$	64,409	$	51,589	$	40,764

Income Taxes

We file income tax returns in the United States federal jurisdiction, numerous states in the United States and multiple countries outside of the United States.

Stock-Based Compensation

Employee Benefit Plans

	Year Ended December 31,
(In thousands)	2018		2017		2016
Company contributions to employee benefit plans	$	29,393	$	18,861	$	18,329

Foreign Currency

Concentrations of Credit Risk

Recently Adopted Accounting Pronouncements

Accounting Pronouncements Not Yet Adopted

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.

Basis of Presentation and Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2018

Accounting Policies [Abstract]

Schedule of Revenue and Associated Cost of Revenue Recast Totals and Gross Profit Impact

	Quarter ended												Year ended
(In thousands)	March 31, 2018			June 30, 2018			September 30, 2018			December 31, 2018			December 31, 2018
Cost of revenue reclassification:
Software delivery, support and maintenance	$	(4,033	)	$	(7,202	)	$	(6,394	)	$	(6,400	)	$	(24,029	)
Client services		4,033			7,202			6,394			6,400			24,029
Amortization of software development and acquisition-related assets		0			0			0			0			0
Total cost of revenue:		0			0			0			0			0

Gross profit impact:
Software delivery, support and maintenance		(4,033	)		(7,202	)		(6,394	)		(6,400	)		(24,029	)
Client services		4,033			7,202			6,394			6,400			24,029
Total gross profit	$	0		$	0		$	0		$	0		$	0

The following table illustrates the recast for revenue and associated cost of revenue for the quarterly periods and the year ended December 31, 2017:

	Quarter ended												Year ended
(In thousands)	March 31, 2017			June 30, 2017			September 30, 2017			December 31, 2017			December 31, 2017
Revenue reclassification:
Software delivery, support and maintenance	$	(4,270	)	$	(4,239	)	$	(5,119	)	$	(4,703	)	$	(18,331	)
Client services		4,270			4,239			5,119			4,703			18,331
Total revenue		0			0			0			0			0

Cost of revenue reclassification:
Software delivery, support and maintenance		(5,056	)		(5,556	)		(5,454	)		(5,454	)		(21,520	)
Client services		5,056			5,556			5,454			5,454			21,520
Amortization of software development and acquisition-related assets		0			0			0			0			0
Total cost of revenue:		0			0			0			0			0

Gross profit impact:
Software delivery, support and maintenance		786			1,317			335			751			3,189
Client services		(786	)		(1,317	)		(335	)		(751	)		(3,189	)
Total gross profit	$	0		$	0		$	0		$	0		$	0

The following table illustrates the recast of revenue and associated cost of revenue for the year ended December 31, 2016:

	Year ended
(In thousands)	December 31, 2016
Revenue reclassification:
Software delivery, support and maintenance	$	(8,734	)
Client services		8,734
Total revenue		0

Cost of revenue reclassification:
Software delivery, support and maintenance		(17,831	)
Client services		17,831
Amortization of software development and acquisition-related assets		0
Total cost of revenue:		0

Gross profit impact:
Software delivery, support and maintenance		9,097
Client services		(9,097	)
Total gross profit	$	0

Unamortized Balances of Capitalized Software

The unamortized balances of capitalized software were as follows:

	December 31,
(In thousands)	2018			2017
Software development costs	$	317,637		$	280,146
Less: accumulated amortization		(107,977	)		(85,301	)
Software development costs, net	$	209,660		$	194,845

Capitalized Software Development Costs, Write Offs Included in Asset Impairment Changes and Amortization of Capitalized Software Development Costs Included in Cost of Revenue

	Year Ended December 31,
(In thousands)	2018		2017		2016
Capitalized software development costs	$	113,308	$	94,740	$	115,710
Write-offs and divestitures of capitalized software development costs	$	34,083	$	0	$	4,625
Amortization of capitalized software development costs	$	64,409	$	51,589	$	40,764

Company Contributions to Employee Benefit Plan

	Year Ended December 31,
(In thousands)	2018		2017		2016
Company contributions to employee benefit plans	$	29,393	$	18,861	$	18,329

Revenue from Contracts with Customers (Tables)

12 Months Ended

Dec. 31, 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		Three Months Ended December 31, 2018
Revenue related to deferred revenue balance at beginning of period	$	181,398	$	196,163	$	153,151	$	141,127
Revenue related to new performance obligations satisfied during the period		200,232		180,001		225,641		237,963
Revenue recognized under "right-to-invoice" expedient		49,403		62,533		51,288		60,593
Reimbursed travel expenses, shipping and other revenue		2,689		2,767		2,350		2,663
Total revenue	$	433,722	$	441,464	$	432,430	$	442,346

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:

	Year Ended December 31,
(In thousands)	2018		2017		2016
Revenue:
Software delivery, support and maintenance
Recurring revenue	$	967,990	$	802,080	$	752,084
Non-recurring revenue		160,273		156,107		147,215
Total software delivery, support and maintenance		1,128,263		958,187		899,299
Client services
Recurring revenue	$	443,752	$	374,640	$	324,635
Non-recurring revenue		177,947		164,881		162,135
Total client services		621,699		539,521		486,770
Total revenue	$	1,749,962	$	1,497,708	$	1,386,069

Disaggregation of Revenue by Product Line and Segment

	Twelve Months Ended December 31, 2018
(In thousands)	Clinical and Financial Solutions		Population Health		Unallocated			Total
Software delivery, support and maintenance	$	958,144	$	168,275	$	1,844		$	1,128,263
Client services		607,843		22,431		(8,575	)		621,699
Total revenue	$	1,565,987	$	190,706	$	(6,731	)	$	1,749,962

	Twelve Months Ended December 31, 2017
(In thousands)	Clinical and Financial Solutions		Population Health		Unallocated			Total
Software delivery, support and maintenance	$	808,611	$	160,015	$	(10,439	)	$	958,187
Client services		528,419		13,794		(2,692	)		539,521
Total revenue	$	1,337,030	$	173,809	$	(13,131	)	$	1,497,708

	Twelve Months Ended December 31, 2016
(In thousands)	Clinical and Financial Solutions		Population Health		Unallocated		Total
Software delivery, support and maintenance	$	710,679	$	165,532	$	23,088	$	899,299
Client services		472,517		11,862		2,391		486,770
Total revenue	$	1,183,196	$	177,394	$	25,479	$	1,386,069

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 consolidated balance sheet as of December 31, 2017.

	As Reported			Adjustments			Adjusted
(In thousands)	December 31, 2017			due to ASC 606			January 1, 2018
Accounts receivable, net	$	492,560		$	(19,290	)	$	473,270
Contract assets		0			77,791			77,791
Prepaid expenses and other current assets		106,455			7,381			113,836

Deferred revenue, current		478,574			(12,810	)		465,764
Deferred revenue, long-term		19,208			0			19,208
Deferred taxes, net		23,258			20,034			43,292
Accumulated deficit		(338,150	)		58,658			(279,492	)

	December 31, 2018
(In thousands)	As reported under ASC 606		Adjustments due to ASC 606			Pro forma under ASC 605
Accounts receivable, net	$	465,264	$	54,489		$	519,753
Contract assets		66,451		(66,451	)		0
Prepaid expenses and other current assets		142,455		(7,719	)		134,736
Contract assets - long-term		71,879		(71,879	)		0

Deferred revenue, current		466,797		14,691			481,488
Deferred taxes, net		58,470		(27,195	)		31,275
Retained earnings		132,842		(79,056	)		53,786

	Twelve Months Ended December, 31, 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	$	1,128,263		$	(21,780	)	$	1,106,483
Client services		621,699			(6,185	)		615,514
Gross profit		724,543			(26,906	)		697,637
Selling, general and administrative expenses		450,967			(176	)		450,791
Loss from operations		(93,052	)		(26,730	)		(119,782	)
Income (loss) from continuing operations before income taxes		13,138			(27,559	)		(14,421	)
Income tax (provision) benefit		(469	)		7,160			6,691
Income (loss) from continuing operations, net of tax		12,669			(20,399	)		(7,730	)
Net income attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	363,740		$	(20,399	)	$	343,341
Earnings per share - basic attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	2.07		$	(0.12	)	$	1.95
Earnings per share - diluted attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	2.04		$	(0.11	)	$	1.93

Business Combinations and Other Investments (Tables)

12 Months Ended

Dec. 31, 2018

Proforma Results

	(Unaudited) Year Ended December 31,
(In thousands, except per share amounts)	2018 ⁽²⁾	2017
Actual from NantHealth since acquisition date of August 25, 2017:
Revenue	n/a	$	6,268
Net loss	n/a	$	(4,393	)

Actual from EIS Business since acquisition date of October 2, 2017: ⁽¹⁾
Revenue	n/a	$	77,046
Net loss	n/a	$	(15,160	)

Supplemental pro forma data for combined entity:
Revenue	n/a	$	1,768,530
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	n/a	$	(192,653	)
Loss per share, basic and diluted	n/a	$	(1.07	)

______________________

⁽¹⁾	Revenue and Net loss from the EIS Business excludes revenue and income from discontinued operations. Refer to Note 16, “Discontinued Operations”.

⁽²⁾	Pro forma information is not applicable as the results of NantHealth and the EIS Business were fully consolidated in consolidated statements of operations for the year ended December 31, 2018.

Summary of Other Equity Investments Included in Other Assets

The following table summarizes our other 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 December 31, 2018		Cost		December 31, 2018		December 31, 2017
Equity method investments ⁽¹⁾		8	$	7,407	$	10,667	$	4,258
Cost method investments		5		37,874		25,923		22,020
Total long-term equity investments		13	$	45,281	$	36,590	$	26,278

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

	(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

Practice Fusion, Inc. [Member]

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

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

	(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		67,100
Goodwill		35,092
Other assets		42
Accounts payable and accrued expenses		(7,378	)
Deferred revenue		(2,400	)
Long-term deferred tax liability		(8,853	)
Other liabilities		(815	)
Net assets acquired	$	113,640

NantHealth, Inc. [Member]

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	$	29,000
Customer Relationships - Pharmaceutical Partners	20		19,400
Technology	8		14,800
Tradenames	10		3,900
		$	67,100

Schedule of Consideration Funded by Sources of Funds

Total consideration for the transaction was as follows:

	(In thousands)
Cash	$	1,742
Add: Final net working capital surplus		1,022
Add: NantHealth common stock		42,750
Less: Value assigned to modification of existing commercial agreement with NantHealth		(22,900	)
Total consideration for NantHealth provider/patient solutions business	$	22,614

	(In thousands)
Cash and cash equivalents	$	21
Accounts receivable, net		2,069
Prepaid expenses and other current assets		1,735
Fixed assets		3,401
Intangible assets		12,400
Goodwill		13,466
Other assets		204
Accounts payable and accrued expenses		(1,477	)
Deferred revenue		(9,205	)
Net assets acquired	$	22,614

Schedule of Consideration Funded by Sources of Funds

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

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Customer Relationships	19	$	9,200
Technology	5		3,000
Tradenames	5		200
		$	12,400

EIS Business [Member]

The net consideration paid was funded through incremental borrowings under our debt facilities.

	(In thousands)
Aggregate purchase price	$	185,000
Add: Final net working capital surplus		1,331
Less: Assumption of restructuring indebtedness		(16,834	)
Net consideration paid in cash for the EIS Business	$	169,497

	(In thousands)
Cash and cash equivalents	$	1,068
Accounts receivable, net		72,996
Prepaid expenses and other current assets		19,358
Fixed assets		9,808
Intangible assets		143,000
Goodwill		61,337
Other assets		1,601
Accounts payable and accrued expenses		(34,285	)
Deferred revenue		(102,523	)
Other liabilities		(2,863	)
Net assets acquired	$	169,497

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

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Customer Relationships	10	$	80,800
Technology	7		58,400
Tradenames	7		3,800
		$	143,000

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2018

Fair Value Disclosures [Abstract]

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	December 31, 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	$	262	$	0	$	262	$	0	$	1,136	$	0	$	1,136
1.25% Call Option	Other assets		0		0		9,104		9,104		0		0		46,578		46,578
Total assets		$	0	$	262	$	9,104	$	9,366	$	0	$	1,136	$	46,578	$	47,714

Contingent consideration	Accrued expenses	$	0	$	0	$	10,528	$	10,528	$	0	$	0	$	1,950	$	1,950
Contingent consideration	Other liabilities		0		0		15,317		15,317		0		0		5,086		5,086
1.25% Embedded cash conversion option	Other liabilities		0		0		9,974		9,974		0		0		47,777		47,777
Total liabilities		$	0	$	0	$	35,819	$	35,819	$	0	$	0	$	54,813	$	54,813

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 December 31, 2018 are summarized as follows:


(In thousands)	Contingent Consideration			1.25% Notes Call Spread Overlay
Balance at December 31, 2016	$	5,285		$	(579	)
Additions		1,923			0
Payments		(171	)		0
Fair value adjustments		(1	)		(620	)
Balance at December 31, 2017		7,036			(1,199	)
Additions		24,551			0
Payments		(6,067	)		0
Fair value adjustments		325			329
Balance at December 31, 2018	$	25,845		$	(870	)

Fixed Assets (Tables)

12 Months Ended

Dec. 31, 2018

Property Plant And Equipment [Abstract]

Fixed Assets

Fixed assets consist of the following:

	Estimated	December 31,			December 31,
(Dollar amounts in thousands)	Useful Life	2018			2017
Computer equipment and software	3 to 10 years	$	332,826		$	316,537
Facility furniture, fixtures and equipment	5 to 7 years		21,300			23,923
Leasehold improvements	Shorter of 7 years or life of lease		37,555			33,031
Assets under capital leases	3 to 5 years		9,435			7,203
Fixed assets, gross			401,116			380,694
Less: Accumulated depreciation and amortization			(279,203	)		(245,277	)
Fixed assets, net		$	121,913		$	135,417

Depreciation and Amortization Expense

Fixed assets depreciation and amortization expense were as follows:

	Year Ended December 31,
(In thousands)	2018		2017		2016
Fixed assets depreciation and amortization expense, including capital leases	$	47,567	$	40,717	$	34,314

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2018

Goodwill And Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

Goodwill and intangible assets consist of the following:

	December 31, 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	$	537,834	$	(401,093	)	$	136,741	$	533,044	$	(365,828	)	$	167,216
Customer contracts and relationships		704,808		(462,468	)		242,340		654,849		(438,492	)		216,357
Total	$	1,242,642	$	(863,561	)	$	379,081	$	1,187,893	$	(804,320	)	$	383,573

Intangibles not subject to amortization:
Registered trademarks						$	52,000						$	52,000
Goodwill							1,373,744							1,292,747
Total						$	1,425,744						$	1,344,747

Changes in Carrying Amount of Goodwill

Changes in the carrying amounts of goodwill by reportable segment for the years ended December 31, 2018 and 2017 were as follows:

	Clinical and			Population
(In thousands)	Financial Solutions			Health			Total
Balance as of December 31, 2016	$	843,837		$	404,875		$	1,248,712
Additions arising from business acquisitions:
NantHealth provider/patient solutions business		0			13,350			13,350
Enterprise Information Solutions business		16,367			12,860			29,227
Other additions		420			47			467
Total additions to goodwill		16,787			26,257			43,044
Foreign exchange translation		991			0			991
Balance as of December 31, 2017	$	861,615		$	431,132		$	1,292,747
Additions arising from business acquisitions:
Practice Fusion		35,092			0			35,092
Health Grid		0			53,953			53,953
Other additions		6,399			0			6,399
Total arising from business acquisitions		41,491			53,953			95,444
Increases due to measurement period adjustments related to prior year acquisitions:
NantHealth provider/patient solutions business		0			116			116
Enterprise Information Solutions business		25,192			6,857			32,049
Total increases due to measurement period adjustments:		25,192			6,973			32,165
Total additions to goodwill		66,683			60,926			127,609
Divestitures		0			(32,306	)		(32,306	)
Goodwill impairment charge		0			(13,466	)		(13,466	)
Transfers		2,904			(2,904	)		0
Foreign exchange translation		(840	)		0			(840	)
Balance as of December 31, 2018	$	930,362		$	443,382		$	1,373,744

Amortization Expense Related to Intangible Assets

Intangible assets are being amortized over their estimated useful lives and amortization expense related to intangible assets was as follows:

	Year Ended December 31,
(In thousands)	2018		2017		2016
Proprietary technology amortization included in cost of revenue	$	38,467	$	33,137	$	30,451
Intangible amortization included in operating expenses		26,587		17,345		15,884
Total intangible amortization expense	$	65,054	$	50,482	$	46,335

Estimated Future Amortization Expense for Intangible Assets


Year Ended December 31,	(In thousands)
2019	$	63,010
2020		58,356
2021		52,928
2022		46,472
2023		30,272
Thereafter		128,043
Total	$	379,081

Asset Impairment Charges (Tables)

12 Months Ended

Dec. 31, 2018

Asset Impairment Charges [Abstract]

Summary of Non-Cash Asset Impairment Charges

The following table summarizes the non-cash asset impairment charges recorded during the periods indicated and where they appear in the corresponding consolidated statements of operations:

	Year Ended December 31,
(In thousands)	2018		2017		2016
Asset impairment charges	$	58,166	$	0	$	4,650
Goodwill impairment charge	$	13,466	$	0	$	0
Impairment of long-term investments	$	15,487	$	165,290	$	0

Debt (Tables)

12 Months Ended

Dec. 31, 2018

Debt Outstanding Excluding Capital Lease Obligations

Debt outstanding, excluding capital lease obligations, consisted of the following:

	December 31, 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	$	22,112	$	322,888	$	345,000	$	35,978	$	309,022
Senior Secured Credit Facility		350,000		6,038		343,962		628,750		3,360		625,390
Other debt		748		0		748		0		0		0
Total debt	$	695,748	$	28,150	$	667,598	$	973,750	$	39,338	$	934,412
Less: Debt payable within one year		20,538		479		20,059		28,125		438		27,687
Total long-term debt, less current maturities	$	675,210	$	27,671	$	647,539	$	945,625	$	38,900	$	906,725

Interest Expense

Interest expense consisted of the following:

	Year Ended December 31,
(In thousands)	2018		2017		2016
Interest expense	$	35,366	$	23,001	$	15,556
Amortization of discounts and debt issuance costs		15,548		14,539		13,922
Total interest expense	$	50,914	$	37,540	$	29,478

Summary of Future Debt Payments

The following table summarizes future debt payments as of December 31, 2018:

(In thousands)	Total		2019		2020		2021		2022		2023		Thereafter
1.25% Cash Convertible Senior Notes ⁽¹⁾	$	345,000	$	0	$	345,000	$	0	$	0	$	0	$	0
Term Loan		350,000		20,000		27,500		30,000		37,500		235,000		0
Other debt		748		538		210		0		0		0		0
Total debt	$	695,748	$	20,538	$	372,710	$	30,000	$	37,500	$	235,000	$	0

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

Interest Expense Related to 1.25% Cash Convertible Senior Notes

Interest expense related to the 1.25% Cash Convertible Senior Notes, which is included in total interest expense above, was comprised of the following:

	Year Ended December 31,
(In thousands)	2018		2017		2016
Coupon interest at 1.25%	$	4,312	$	4,312	$	4,312
Amortization of discounts and debt issuance costs		13,867		13,208		12,585
Total interest expense related to the 1.25% Notes	$	18,179	$	17,520	$	16,897

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2018

Income Tax Disclosure [Abstract]

Geographic Breakdown of Income (Loss) Before Income Tax Benefits

The following is a geographic breakdown of income (loss) before income tax benefits:


	Year Ended December 31,
(In thousands)	2018			2017			2016
United States	$	14,045		$	(190,053	)	$	33,027
Foreign		(907	)		16			(1,467	)
Income (loss) from continuing operations before income taxes	$	13,138		$	(190,037	)	$	31,560

Components of Provision (Benefit) for Income Taxes

The following is a summary of the components of the provision (benefit) for income taxes:


	Year Ended December 31,
(In thousands)	2018			2017			2016
Current tax provision
Federal	$	838		$	407		$	372
State		737			1,796			625
Foreign		5,015			5,091			3,857
		6,590			7,294			4,854
Deferred tax provision
Federal		(5,781	)		2,800			(3,784	)
State		236			(12,695	)		116
Foreign		(576	)		(2,913	)		(877	)
		(6,121	)		(12,808	)		(4,545	)
Income tax (benefit) provision	$	469		$	(5,514	)	$	309

Taxes Computed at Statutory Federal Income Tax Rate Reconciled to Provision for Income Taxes


	Year Ended December 31,
(In thousands)	2018			2017			2016
United States federal tax at statutory rate	$	2,759		$	(66,523	)	$	10,869
Items affecting federal income tax rate
Non-deductible acquisition and reorganization expenses		291			0			1,400
Research credits		(6,185	)		(3,200	)		(2,700	)
Change in unrecognized tax benefits		3			395			(692	)
State income taxes, net of federal benefit		715			(7,121	)		1,931
Compensation		3,213			2,950			651
Meals and entertainment		616			991			1,085
Impact of foreign operations		3,627			730			2,847
Provision-to-Return adjustments		(2,140	)		(1,413	)		(1,116	)
Deemed Dividends		373			1,289			887
Dividends Accrued or Received		0			0			2,198
Federal, state and local rate changes		0			185			344
US Tax reform impact		0			10,189			0
One time Mandatory Repatriation Toll Charge		0			5,155			0
Non-deductible items		34			33			51
Noncontrolling interest		951			0			0
True-up of prior year income of Consolidated Investment		913			0			0
Valuation allowance		(5,208	)		47,959			(17,504	)
Other		507			2,867			58
Income tax provision (benefit)	$	469		$	(5,514	)	$	309

Components of Deferred Tax Assets and Liabilities

Significant components of our deferred tax assets and liabilities consist of the following:

	December 31,
(In thousands)	2018			2017
Deferred tax assets
Accruals and reserves, net	$	31,565		$	23,658
Allowance for doubtful accounts		11,378			6,014
Stock-based compensation, net		10,595			10,442
Deferred revenue		8,160			11,502
Net operating loss carryforwards		36,649			41,428
Capital loss carryforwards		0			42,702
Research and development tax credit		899			32,907
AMT credits		0			7,538
Other		10,784			11,108
Less: Valuation Allowance		(18,734	)		(79,594	)
Total deferred tax assets		91,296			107,705

Deferred tax liabilities
Prepaid expense		(6,733	)		(6,166	)
Property and equipment, net		(7,442	)		(8,464	)
Acquired intangibles, net		(129,879	)		(111,112	)
Other		(676	)		(647	)
Total deferred tax liabilities		(144,730	)		(126,389	)
Net deferred tax liabilities	$	(53,434	)	$	(18,684	)

Schedule Of Deferred Tax Assets And Liabilities Classified In Consolidated Balance Sheets

The deferred tax assets (liabilities) are classified in the consolidated balance sheets as follows:


	December 31,
(In thousands)	2018			2017
Non-current deferred tax assets, net	$	5,036		$	4,574
Non-current deferred tax liabilities, net		(58,470	)		(23,258	)
Non-current deferred tax liabilities, net	$	(53,434	)	$	(18,684	)

Change in the Amount of Unrecognized Tax Benefits

Changes in the amounts of unrecognized tax benefits were as follows:

	Year Ended December 31,
(In thousands)	2018			2017			2016
Beginning balance as of January 1	$	10,939		$	10,616		$	11,777
Increases for tax positions related to the current year		8,977			640			570
Decreases for tax positions related to prior years		0			(146	)		0
Increases for tax positions related to prior years		367			153			104
Increases acquired in business acquisitions		540			0			0
Foreign currency translation		(5	)		10			(1	)
Reductions due to lapsed statute of limitations		(997	)		(334	)		(1,834	)
Ending balance as of December 31	$	19,821		$	10,939		$	10,616

Recognized Interest and Penalties Related to Uncertain Tax Positions

We recognized interest and penalties related to uncertain tax positions in our consolidated statements of operations as follows:


	Year Ended December 31,
(In thousands)	2018		2017		2016
Interest and penalties included in the provision for income taxes	$	543	$	446	$	6

Amount of Interest and Penalties Included in Consolidated Balance Sheets

The amount of interest and penalties included in our consolidated balance sheets is as follows:


	December 31,
(In thousands)	2018		2017
Interest and penalties included in the liability for uncertain tax positions	$	198	$	741

Stock Award Plan (Tables)

12 Months Ended

Dec. 31, 2018

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Stock-Based Compensation Expense

	Year Ended December 31,
(In thousands)	2018		2017		2016
Cost of revenue:
Software delivery, support and maintenance	$	2,184	$	2,879	$	4,125
Client services		3,997		4,484		4,363
Total cost of revenue		6,181		7,363		8,488
Selling, general and administrative expenses		24,213		23,497		21,829
Research and development		8,937		8,605		8,029
Total stock-based compensation expense	$	39,331	$	39,465	$	38,346

Activity for Restricted Stock Awards

The following table summarizes the activity for restricted stock units during the periods presented:

				Weighted-Average
(In thousands, except per share amounts)	Shares			Grant Date Fair Value
Unvested restricted stock units as of December 31, 2015		5,379		$	14.15
Awarded		3,480			12.88
Vested		(2,095	)		13.84
Forfeited		(517	)		14.30
Unvested restricted stock units as of December 31, 2016		6,247			13.54
Awarded		3,690			12.52
Vested		(1,835	)		13.74
Forfeited		(843	)		16.97
Unvested restricted stock units as of December 31, 2017		7,259			12.57
Awarded		4,024			13.25
Vested		(2,222	)		13.03
Forfeited		(1,111	)		12.43
Unvested restricted stock units as of December 31, 2018		7,950		$	12.81

Stock Options Outstanding

The following table summarizes the status of stock options outstanding and the changes during the periods presented:

	Options			Weighted-Average		Options		Weighted-Average
(In thousands, except per share amounts)	Outstanding			Exercise Price		Exercisable		Exercise Price
Balance as of December 31, 2015		2,343		$	14.24		1,282	$	14.52
Options granted		0			0.00
Options exercised		(6	)		14.01
Options forfeited		(434	)		15.51
Balance as of December 31, 2016		1,903			13.95		1,431		13.98
Options granted		0			0.00
Options exercised		(108	)		14.01
Options forfeited		(160	)		15.00
Balance as of December 31, 2017		1,635			13.85		1,635		13.85
Options granted		0			0.00
Options exercised		(92	)		14.01
Options forfeited		(211	)		14.74
Balance as of December 31, 2018		1,332		$	13.69		1,332	$	13.69

Stock Option Activity

The following activity occurred under the Plan:

	Year Ended December 31,
(In thousands)	2018		2017		2016
Total intrinsic value of stock options exercised	$	69	$	45	$	1
Total fair value of share awards vested	$	28,954	$	25,220	$	26,892

Stock Option Awards

The following table summarizes information about stock options outstanding under the Plan as of December 31, 2018:

	Number of				Number of
	Options		Weighted-Average		Options		Weighted-Average
Range of Exercise Prices	Outstanding		Exercise Price		Exercisable		Exercise Price
$12.72 to $14.01		1,323,447	$	13.69		1,323,447	$	13.69
$14.78 to $15.22		8,239	$	14.81		8,239	$	14.81
		1,331,686				1,331,686

Earnings (Loss) Per Share (Tables)

12 Months Ended

Dec. 31, 2018

Earnings Per Share [Abstract]

Calculations of Earnings (Loss) Per Share

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

	Year Ended December 31,
(In thousands, except per share amounts)	2018			2017			2016
Basic Income (Loss) per Common Share:
Income (loss) from continuing operations, net of tax	$	12,669		$	(184,523	)	$	31,251
Less: Net loss (income) attributable to non-controlling interests		4,527			1,566			(146	)
Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	17,196		$	(182,957	)	$	31,105
Income (loss) from discontinued operations, net of tax		395,138			30,348			(28,221	)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations		(48,594	)		(43,850	)		(28,536	)
Net income (loss) from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders		346,544			(13,502	)		(56,757	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	363,740		$	(196,459	)	$	(25,652	)

Weighted-average common shares outstanding		176,038			180,830			186,188

Basic Income (Loss) from continuing operations per Common Share	$	0.10		$	(1.02	)	$	0.17
Basic Income (Loss) from discontinued operations per Common Share	$	1.97		$	(0.07	)	$	(0.31	)
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	2.07		$	(1.09	)	$	(0.14	)

Diluted Income (Loss) per Common Share:
Income (loss) from continuing operations, net of tax	$	12,669		$	(184,523	)	$	31,251
Less: Net loss (income) attributable to non-controlling interests		4,527			1,566			(146	)
Net income (loss) from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	17,196		$	(182,957	)	$	31,105
Income (loss) from discontinued operations, net of tax	$	395,138		$	30,348		$	(28,221	)
Less: Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations		(48,594	)		(43,850	)		(28,536	)
Net income (loss) from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders		346,544			(13,502	)		(56,757	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	363,740		$	(196,459	)	$	(25,652	)

Weighted-average common shares outstanding		176,038			180,830			186,188
Dilutive effect of stock options, restricted stock unit awards and warrants		2,491			0			0
Weighted-average common shares outstanding assuming dilution		178,529			180,830			186,188

Diluted Income (Loss) from continuing operations per Common Share	$	0.10		$	(1.02	)	$	0.17
Diluted Income (Loss) from discontinued operations per Common Share	$	1.94		$	(0.07	)	$	(0.31	)
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	2.04		$	(1.09	)	$	(0.14	)

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

Year Ended December 31,

(In thousands)

2018

2017

2016

Shares subject to anti-dilutive stock options, restricted stock unit awards and

warrants excluded from calculation

26,175

26,515

25,277

Accumulated Other Comprehensive Loss (Tables)

12 Months Ended

Dec. 31, 2018

Equity [Abstract]

Components of Accumulated Other Comprehensive Loss

(In thousands)	Foreign Currency Translation Adjustments			Unrealized Net Gains (Losses) on Available for Sale Securities			Unrealized Net Gains (Losses) on Foreign Exchange Contracts			Total
Balance as of December 31, 2015 ⁽¹⁾	$	(4,500	)	$	0		$	258		$	(4,242	)
Other comprehensive (loss) income before reclassifications		(1,528	)		(56,420	)		683			(57,265	)
Net losses (gains) reclassified from accumulated other comprehensive loss		0			0			(322	)		(322	)
Net other comprehensive (loss) income		(1,528	)		(56,420	)		361			(57,587	)
Balance as of December 31, 2016 ⁽²⁾		(6,028	)		(56,420	)		619			(61,829	)
Other comprehensive (loss) income before reclassifications		3,352			(106,445	)		1,697			(101,396	)
Net losses (gains) reclassified from accumulated other comprehensive loss		0			162,865			(1,625	)		161,240
Net other comprehensive (loss) income		3,352			56,420			72			59,844
Balance as of December 31, 2017 ⁽³⁾		(2,676	)		0			691			(1,985	)
Other comprehensive (loss) income before reclassifications		(2,908	)		0			(264	)		(3,172	)
Net losses (gains) reclassified from accumulated other comprehensive loss		0			0			(232	)		(232	)
Net other comprehensive (loss) income		(2,908	)		0			(496	)		(3,404	)
Balance as of December 31, 2018 ⁽⁴⁾	$	(5,584	)	$	0		$	195		$	(5,389	)

⁽¹⁾ Net of taxes of $166 thousand for unrealized net gains on marketable securities and foreign exchange contract derivatives

⁽²⁾ Net of taxes of $463 thousand for unrealized net gains on marketable securities and foreign exchange contract derivatives

⁽³⁾ Net of taxes of $445 thousand for unrealized net gains on foreign exchange contract derivatives

⁽⁴⁾ Tax effects for the year ended December 31, 2018 include $149 thousand arising from the revaluations of tax effects included in accumulated other comprehensive income.

Income Tax Effects Related to Components of Other Comprehensive Loss

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

	Year Ended December 31, 2018
(In thousands)	Before-Tax Amount			Tax Effect		Net Amount
Foreign currency translation adjustments	$	(2,908	)	$	0	$	(2,908	)
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net (losses) gains arising during the period		(357	)		93		(264	)
Net (gains) losses reclassified into income ⁽¹⁾		(516	)		284		(232	)
Net change in unrealized (losses) gains on foreign exchange contracts		(873	)		377		(496	)
Net gain (loss) on cash flow hedges		(873	)		377		(496	)
Other comprehensive loss	$	(3,781	)	$	377	$	(3,404	)

⁽¹⁾ Net of taxes of $68 thousand for unrealized net gains on foreign exchange contract derivatives

	Year Ended December 31, 2017
(In thousands)	Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	3,352		$	0		$	3,352
Available for sale securities:
Net gain arising during the period		(106,506	)		61			(106,445	)
Net gain reclassified into income		162,865			0			162,865
Net change in unrealized gains on available for sale securities		56,359			61			56,420
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period		2,776			(1,079	)		1,697
Net (gains) losses reclassified into income		(2,662	)		1,037			(1,625	)
Net change in unrealized gains (losses) on foreign exchange contracts		114			(42	)		72
Net gain (loss) on cash flow hedges		114			(42	)		72
Other comprehensive loss	$	59,825		$	19		$	59,844

	Year Ended December 31, 2016
(In thousands)	Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	(1,528	)	$	0		$	(1,528	)
Available for sale securities:
Net gain arising during the period		(56,359	)		(61	)		(56,420	)
Net gain reclassified into income		0			0			0
Net change in unrealized gains on available for sale securities		(56,359	)		(61	)		(56,420	)
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period		1,128			(445	)		683
Net (gains) losses reclassified into income		(531	)		209			(322	)
Net change in unrealized gains (losses) on foreign exchange contracts		597			(236	)		361
Net gain (loss) on cash flow hedges		597			(236	)		361
Other comprehensive loss	$	(57,290	)	$	(297	)	$	(57,587	)

Derivative Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2018

Derivative Instruments And Hedging Activities Disclosure [Abstract]

Fair Value and Balance Sheet Locations

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

December 31, 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

262

Accrued expenses

Derivatives not subject to hedge accounting:

1.25% Call Option

Other assets

9,104

N/A

1.25% Embedded cash conversion option

N/A

Other liabilities

9,974

Total derivatives

9,366

9,974

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

Derivatives Instruments Designated as Cash Flow Hedges

	Amount of Gain (Loss) Recognized in OCI (Effective Portion)							Location of Gain (Loss) Reclassified from AOCI into Income (Effective Portion)	Amount of Gain (Loss) Reclassified from AOCI into Income (Effective Portion)
	Year Ended December 31,								Year Ended December 31,
(In thousands)	2018			2017		2016			2018		2017		2016
Foreign exchange contracts	$	(357	)	$	2,776	$	1,128	Cost of Revenue	$	165	$	905	$	165
								Selling, general and administrative expenses		138		692		133
								Research and development		214		1,065		233

Net Impact of Changes in Fair Value of Call Option and Embedded Cash Conversion Option

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

	Year Ended December 31,
(In thousands)	2018			2017			2016
1.25% Call Option	$	(37,474	)	$	29,498		$	(63,128	)
1.25% Embedded cash conversion option		37,803			(30,118	)		63,551
Net loss included in other income, net	$	329		$	(620	)	$	423

Commitments (Tables)

12 Months Ended

Dec. 31, 2018

Commitments And Contingencies Disclosure [Abstract]

Rent Expense

Total rent expense recognized, which consists of the base rental amount and other lessor charges when mandated in a lease agreement, was as follows:

	Year Ended December 31,
(In thousands)	2018		2017		2016
Rent expense	$	28,677	$	22,499	$	18,113

Future Commitments under Capital and Operating Leases

	Capital			Operating
(In thousands)	Leases			Leases
2019	$	1,351		$	26,330
2020		422			22,394
2021		46			18,824
2022		14			17,493
2023		0			15,582
Thereafter		0			31,658
		1,833		$	132,281
Less amount representing interest		(69	)
		1,764
Current maturities of capital lease obligations		996
Capital lease obligations, net of current maturities	$	768

Summary of Expense Incurred under Atos Agreement

	Year Ended December 31,
(In thousands)	2018		2017		2016
Expenses incurred under Atos agreement	$	55,903	$	58,787	$	62,266

Discontinued Operations (Tables)

12 Months Ended

Dec. 31, 2018

Netsmart [Member]

Summary of Discontinued Operations in Financial Statements

(In thousands)	December 31, 2017
Carrying amounts of major classes of assets associated with Netsmart included as part of assets attributable to discontinued operations:
Cash and cash equivalents	$	31,504
Accounts receivable, net		75,313
Prepaid expenses and other current assets		9,008
Total current assets attributable to Netsmart discontinued operations		115,825

Fixed assets, net		30,186
Software development costs, net		27,344
Intangible assets, net		391,299
Goodwill		712,206
Other assets		1,998
Total noncurrent assets attributable to Netsmart discontinued operations	$	1,163,033

Carrying amounts of major classes of liabilities associated with Netsmart included as part of liabilities attributable to discontinued operations:
Accounts payable	$	11,834
Accrued expenses		8,115
Accrued compensation and benefits		16,560
Deferred revenue		68,256
Current maturities of non-recourse long-term debt - Netsmart		2,755
Current maturities of capital lease obligations		6,763
Total current liabilities attributable to Netsmart		114,283

Non-recourse long-term debt - Netsmart		625,193
Long-term capital lease obligations		4,758
Deferred revenue long-term		4,838
Deferred taxes, net		70,385
Other liabilities		2,342
Total noncurrent liabilities attributable to Netsmart	$	707,516

Redeemable convertible non-controlling interest attributable to discontinued operations	$	431,535
Non-controlling interest attributable to discontinued operations	$	48

The following table summarizes Netsmart’s major income and expense line items as reported in the consolidated statements of operations for the years ended December 31, 2018, 2017 and 2016:

	Year ended December 31,
(In thousands)		2018			2017			2016
Major income and expense line items related to Netsmart:⁽¹⁾
Revenue:
Software delivery, support and maintenance	$	214,065		$	198,204		$	104,319
Client services		131,166			110,430			59,511
Total revenue		345,231			308,634			163,830
Cost of revenue:
Software delivery, support and maintenance		60,100			51,079			36,823
Client services		94,061			78,317			39,851
Amortization of software development and acquisition related assets		34,357			29,876			17,416
Total cost of revenue		188,518			159,272			94,090
Gross profit		156,713			149,362			69,740
Selling, general and administrative expenses		125,807			85,583			58,344
Research and development		25,315			17,937			9,372
Amortization of intangible and acquisition-related assets		24,029			16,409			9,963
(Loss) income from discontinued operations for the Netsmart sale before income taxes		(18,438	)		29,433			(7,939	)
Interest expense		(59,541	)		(49,939	)		(38,663	)
Other income		101			925			258
Income tax benefit		22,933			45,253			18,123
(Loss) income from discontinued operations, net of tax for Netsmart	$	(54,945	)	$	25,672		$	(28,221	)

Horizon Clinicals and Series2000 [Member]

Summary of Discontinued Operations in Financial Statements

The following table summarizes the major classes of assets and liabilities of these discontinued solutions, as reported on the consolidated balance sheets as of December 31, 2018 and 2017:

(In thousands)	December 31, 2018		December 31, 2017
Carrying amounts of major classes of assets associated with Horizon Clinicals and Series2000 Revenue Cycle included as part of assets attributable to discontinued operations:
Accounts receivable, net	$	0	$	8,196
Prepaid expenses and other current assets		0		3,080
Total current 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 liabilities attributable to discontinued operations:
Accounts payable	$	0	$	114
Accrued expenses		920		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 current liabilities attributable to discontinued operations	$	920	$	21,358

	Year ended December 31, 2018
(In thousands)		2018			2017
Major income and expense line items relating to the Horizon Clinicals and Series2000 Revenue Cycle discontinued solutions:
Revenue:
Software delivery, support and maintenance	$	9,441		$	10,949
Client services		404			1,044
Total revenue		9,845			11,993
Cost of revenue:
Software delivery, support and maintenance		2,322			2,918
Client services		830			261
Total cost of revenue		3,152			3,179
Gross profit		6,693			8,814
Research and development		1,651			1,148
Income from discontinued operations for Horizon Clinicals and Series2000 Revenue Cycle before income taxes		5,042			7,666
Income tax provision		(1,311	)		(2,990	)
Income from discontinued operations, net of tax for Horizon Clinicals and Series2000 Revenue Cycle	$	3,731		$	4,676

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 11: http://fasb.org/us-gaap/role/ref/legacyRef
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+ Details

Business Segments (Tables)

12 Months Ended

Dec. 31, 2018

Revenues and Income from Operations Related to Segment Within Reconciliation to Consolidated Amounts

	Year Ended December 31,
(In thousands)	2018			2017			2016
Revenue:
Clinical and Financial Solutions	$	1,565,987		$	1,337,030		$	1,183,196
Population Health		190,706			173,809			177,394
Unallocated Amounts		(6,731	)		(13,131	)		25,479
Total revenue	$	1,749,962		$	1,497,708		$	1,386,069

Gross Profit:
Clinical and Financial Solutions	$	663,005		$	574,386		$	496,595
Population Health		146,614			142,514			149,338
Unallocated Amounts		(85,076	)		(84,101	)		(44,634	)
Total gross profit	$	724,543		$	632,799		$	601,299

Income (loss) from operations:
Clinical and Financial Solutions	$	344,568		$	335,005		$	287,077
Population Health		100,118			112,577			123,685
Unallocated Amounts		(537,738	)		(435,098	)		(343,052	)
Total income (loss) from operations	$	(93,052	)	$	12,484		$	67,710

Supplemental Disclosures (Tables)

12 Months Ended

Dec. 31, 2018

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Supplemental Disclosures

	December 31,
(In thousands)	2018		2017
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents	$	174,243	$	119,470
Restricted cash		10,552		11,524
Total cash, cash equivalents and restricted cash	$	184,795	$	130,994

	Year Ended December 31,
(In thousands)	2018		2017		2016
Cash paid during the period for:
Interest	$	28,888	$	21,183	$	14,989
Income taxes paid, net of tax refunds	$	10,108	$	6,675	$	5,466
Non-cash transactions:
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations	$	48,594	$	43,850	$	28,536
Exchange of NantHealth, Inc. common stock for net assets acquired of NantHealth provider/patient engagement solutions business including value assigned to commercial agreement	$	0	$	42,750	$	0
Obligations incurred to purchase capitalized software or enter into capital leases	$	1,501	$	1,897	$	27,127
Contribution of assets in exchange for equity interest	$	4,000	$	0	$	0
Issuance of treasury stock to commercial partner	$	1,121	$	334	$	0

Accrued Expenses

Accrued expenses consist of the following:

	December 31,		December 31,
(In thousands)	2018		2017
Royalties, certain third-party product costs and licenses	$	26,371	$	14,195
Other		79,701		63,605
Total accrued expenses	$	106,072	$	77,800

Other Assets

Other assets consist of the following:

	December 31,		December 31,
(In thousands)	2018		2017
Reseller agreement with Nant Health, LLC	$	0	$	22,252
Fair value of 1.25% Call Option		9,104		46,578
Long-term deferred hosting fees		20,805		0
Long-term prepaid commissions		32,660		32,938
Investments in non-marketable securities		37,040		30,013
Long-term deposits and other assets		9,597		15,070
Total other assets	$	109,206	$	146,851

Geographic Information (Tables)

12 Months Ended

Dec. 31, 2018

Revenues by Geographic Area

Revenues are attributed to geographic regions based on the location where the sale originated. Our revenues by geographic area are summarized below:

	Year Ended December 31,
(In thousands)	2018		2017		2016
United States	$	1,697,178	$	1,440,842	$	1,336,799
Canada		15,377		15,818		18,694
Other international		37,407		41,048		30,576
Total	$	1,749,962	$	1,497,708	$	1,386,069

Long-Lived Assets by Geographic Area

A summary of our long-lived assets, comprised of fixed assets by geographic area, is presented below:

	December 31,		December 31,
(In thousands)	2018		2017
United States	$	111,836	$	129,021
India		4,231		4,154
Israel		3,830		1,322
Canada		60		146
Other international		1,956		774
Total	$	121,913	$	135,417

Quarterly Financial Information (Unaudited) (Tables)

12 Months Ended

Dec. 31, 2018

Quarterly Financial Information Disclosure [Abstract]

Summary of Quarterly Financial Information

	Quarter Ended
	December 31,			September 30,			June 30,			March 31,
(In thousands, except per share amounts)	2018			2018			2018 ⁽¹⁾			2018 ⁽¹⁾
Revenue	$	442,346		$	432,430		$	441,464		$	433,722
Cost of revenue		254,187			254,478			267,697			249,057
Gross profit		188,159			177,952			173,767			184,665
Selling, general and administrative expenses		99,992			108,125			122,913			119,937
Research and development		66,096			63,032			74,491			64,790
Asset impairment charges		28,091			0			30,075			0
Goodwill impairment charge		13,466			0			0			0
Amortization of intangible and acquisition-related assets		6,957			6,609			6,382			6,639
(Loss) income from operations		(26,443	)		186			(60,094	)		(6,701	)
Interest expense		(13,989	)		(13,251	)		(11,979	)		(11,695	)
Other income (loss), net		658			(536	)		(14	)		(34	)
Gain on sale of businesses, net		0			0			173,129			(871	)
Impairment of and losses on long-term investments		0			0			(9,987	)		(5,500	)
Equity in net (loss) income of unconsolidated investments		(270	)		(177	)		767			(61	)
(Loss) income from continuing operations before income taxes		(40,044	)		(13,778	)		91,822			(24,862	)
Income tax benefit (provision)		5,449			1,637			(7,256	)		(299	)
(Loss) income from continuing operations, net of tax		(34,595	)		(12,141	)		84,566			(25,161	)
Loss from discontinued operations		(39,854	)		(13,857	)		(14,109	)		(5,016	)
Gain on sale of Netsmart		500,471			0			0			0
Income tax effect on discontinued operations		(40,126	)		2,152			3,815			1,662
Income (loss) from discontinued operations, net of tax		420,491			(11,705	)		(10,294	)		(3,354	)
Net income (loss)		385,896			(23,846	)		74,272			(28,515	)
Less: Net loss attributable to non-controlling interest		1,033			4			2,700			790
Less: Accretion redemption preference on redeemable non-controlling interest - discontinued operations		(12,148	)		(12,149	)		(12,148	)		(12,149	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	374,781		$	(35,991	)	$	64,824		$	(39,874	)

Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share:
Basic
Continuing operations	$	(0.19	)	$	(0.07	)	$	0.49		$	(0.14	)
Discontinued operations	$	2.36		$	(0.13	)	$	(0.13	)	$	(0.08	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$	2.17		$	(0.20	)	$	0.36		$	(0.22	)

Diluted
Continuing operations	$	(0.19	)	$	(0.07	)	$	0.49		$	(0.14	)
Discontinued operations	$	2.33		$	(0.13	)	$	(0.13	)	$	(0.08	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$	2.14		$	(0.20	)	$	0.36		$	(0.22	)

	Quarter Ended
	December 31,				September 30,			June 30,			March 31,
(In thousands, except per share amounts)	2017 ⁽²⁾				2017 ⁽²⁾			2017			2017
Revenue	$	436,411			$	368,091		$	350,150		$	343,056
Cost of revenue		260,208				205,843			199,930			198,928
Gross profit		176,203				162,248			150,220			144,128
Selling, general and administrative expenses		123,113				93,790			91,033			92,752
Research and development		68,344				46,485			42,205			45,248
Amortization of intangible and acquisition-related assets		6,005				3,816			3,745			3,779
Income from operations		(21,259	)			18,157			13,237			2,349
Interest expense		(11,594	)			(9,251	)		(8,279	)		(8,416	)
Other income (loss), net		160				(685	)		(222	)		235
Impairment of and losses on long-term investments		0				(20,700	)		(144,590	)		0
Equity in net loss of unconsolidated investments		115				449			(28	)		285
Loss from continuing operations before income taxes		(32,578	)			(12,030	)		(139,882	)		(5,547	)
Income tax benefit (provision)		9,973		⁽³⁾		(1,962	)		(1,263	)		(1,234	)
Loss from continuing operations, net of tax		(22,605	)			(13,992	)		(141,145	)		(6,781	)
Income from discontinued operations, net of tax		37,468				(3,470	)		(1,866	)		(1,784	)
Net income (loss)		14,863				(17,462	)		(143,011	)		(8,565	)
Less: Net loss (income) attributable to non-controlling interest		1,918				(163	)		264			(453	)
Less: Accretion redemption preference on redeemable non-controlling interest - discontinued operations		(10,963	)			(10,962	)		(10,963	)		(10,962	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	5,818			$	(28,587	)	$	(153,710	)	$	(19,980	)

Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share:
Basic
Continuing operations	$	(0.12	)		$	(0.08	)	$	(0.78	)	$	(0.04	)
Discontinued operations	$	0.15			$	(0.08	)	$	(0.07	)	$	(0.07	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$	0.03			$	(0.16	)	$	(0.85	)	$	(0.11	)

Diluted
Continuing operations	$	(0.12	)		$	(0.08	)	$	(0.78	)	$	(0.04	)
Discontinued operations	$	0.15			$	(0.08	)	$	(0.07	)	$	(0.07	)
Net income (loss) attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$	0.03			$	(0.16	)	$	(0.85	)	$	(0.11	)

⁽¹⁾	Results of operations for the quarter include the results of operations of (i) Practice Fusion since February 13, 2018 and (ii) Health Grid since May 18, 2018.

⁽²⁾	Results of operations for the quarter include the results of operations of (i) the provider/ patient engagement solutions business of NantHealth, Inc. since August 25, 2017 and (ii) the EIS Business since October 2, 2017.

⁽³⁾	Income tax benefit (provision) for the quarter ended December 31, 2017, reflects the estimated impact of the United States Tax Cuts and Jobs Act which was enacted on December 22, 2017 and introduced significant changes to the income tax law in the United States.

Schedule of Revenue and Associated Cost of Revenue Recast Totals and Gross Profit Impact (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Basis Of Presentation And Significant Accounting Policies [Line Items]
Total revenue	$ 442,346	$ 432,430	$ 441,464	$ 433,722	$ 436,411	$ 368,091	$ 350,150	$ 343,056	$ 1,749,962	$ 1,497,708	$ 1,386,069
Amortization of software development and acquisition-related assets									102,876	84,725	71,215
Total cost of revenue	254,187	254,478	267,697	249,057	260,208	205,843	199,930	198,928	1,025,419	864,909	784,770
Total gross profit	188,159	177,952	173,767	184,665	176,203	162,248	150,220	144,128	724,543	632,799	601,299
Adjustment [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Total revenue					0	0	0	0		0	0
Amortization of software development and acquisition-related assets	0	0	0	0	0	0	0	0	0	0	0
Total cost of revenue	0	0	0	0	0	0	0	0	0	0	0
Total gross profit	0	0	0	0	0	0	0	0	0	0	0
Software delivery, Support and Maintenance [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Total revenue									1,128,263	958,187	899,299
Total cost of revenue									357,039	295,593	276,401
Software delivery, Support and Maintenance [Member] \| Adjustment [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Total revenue					(4,703)	(5,119)	(4,239)	(4,270)		(18,331)	(8,734)
Total cost of revenue	(6,400)	(6,394)	(7,202)	(4,033)	(5,454)	(5,454)	(5,556)	(5,056)	(24,029)	(21,520)	(17,831)
Total gross profit	(6,400)	(6,394)	(7,202)	(4,033)	751	335	1,317	786	(24,029)	3,189	9,097
Client services [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Total revenue									621,699	539,521	486,770
Total cost of revenue									565,504	484,591	437,154
Client services [Member] \| Adjustment [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Total revenue					4,703	5,119	4,239	4,270		18,331	8,734
Total cost of revenue	6,400	6,394	7,202	4,033	5,454	5,454	5,556	5,056	24,029	21,520	17,831
Total gross profit	$ 6,400	$ 6,394	$ 7,202	$ 4,033	$ (751)	$ (335)	$ (1,317)	$ (786)	$ 24,029	$ (3,189)	$ (9,097)

Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) - USD ($)	3 Months Ended		12 Months Ended
	Sep. 30, 2017	Jun. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Basis Of Presentation And Significant Accounting Policies [Line Items]
Other-than-temporary impairments		$ 142,200,000	$ 0		$ 0
Capitalized software development costs			$ 113,308,000	$ 94,740,000	115,710,000
Percentage of revenues			No single client accounted for more than 10% of our revenue in the years ended December 31, 2018, 2017 and 2016.
Customer concentration			No client represented more than 10% of accounts receivable as of December 31, 2018 or 2017.
ASU 2016-02 [Member] \| Adoption of ASU 2016-02 Estimated Values [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Right of use assets			$ 105,000,000
Lease liabilities			$ 125,000,000
Third-Party Software Purchases [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Capitalized software development costs					44,000,000
Accrued Software Development Cost					$ 24,000,000
Minimum [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Capitalized software estimated economic life			3 years
Maximum [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Capitalized software estimated economic life			5 years
1.25% Cash Convertible Senior Notes [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Interest rate			1.25%
Nant Health, LLC [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Loss on disposition of available for sale instruments	$ (20,700,000)

Unamortized Balances of Capitalized Software (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Accounting Policies [Abstract]
Software development costs	$ 317,637	$ 280,146
Less: accumulated amortization	(107,977)	(85,301)
Software development costs, net	$ 209,660	$ 194,845

Capitalized Software Development Costs, Write Offs Included in Asset Impairment Changes and Amortization of Capitalized Software Development Costs Included in Cost of Revenue (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Accounting Policies [Abstract]
Capitalized software development costs	$ 113,308	$ 94,740	$ 115,710
Write-offs and divestitures of capitalized software development costs	34,083	0	4,625
Amortization of capitalized software development costs	$ 64,409	$ 51,589	$ 40,764

Company Contributions to Employee Benefit Plan (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Accounting Policies [Abstract]
Company contributions to employee benefit plans	$ 29,393	$ 18,861	$ 18,329

Revenue from Contracts with Customers - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2018 USD ($) Revenue_Stream	Jan. 01, 2018 USD ($)	Dec. 31, 2017 USD ($)
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Number of primary revenue streams \| Revenue_Stream	2
Deferred costs for fulfilment of contract	$ 20,805		$ 0
Total backlog	$ 3,900,000
Total backlog, percentage, year one	39.00%
Total backlog, percentage after year one	61.00%
Selling, General and Administrative Expenses [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost Amortization	$ 29,700
Prepaid Expenses and Other Current Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross	24,700
Other Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross	$ 33,800
ASC 606
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Deferred costs for fulfilment of contract		$ 5,500
ASC 606 \| Minimum [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized cost, amortization period	2 years
ASC 606 \| Maximum [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized cost, amortization period	6 years

Revenue from Contracts with Customers - Impact of Adoption on Previously Reported Condensed Consolidated Balance Sheet (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Jan. 01, 2018	Dec. 31, 2017
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable, net	$ 465,264		$ 492,560
Contract assets	66,451		0
Prepaid expenses and other current assets	142,455		106,455
Deferred revenue, current	466,797		478,574
Deferred revenue, long-term			19,208
Deferred taxes, net	58,470		23,258
Retained earnings (accumulated deficit)	132,842		$ (338,150)
ASC 606
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable, net		$ 473,270
Contract assets		77,791
Prepaid expenses and other current assets		113,836
Deferred revenue, current		465,764
Deferred revenue, long-term		19,208
Deferred taxes, net		43,292
Retained earnings (accumulated deficit)		(279,492)
ASC 606 \| Adjustments Due to ASC 606 [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Accounts receivable, net	54,489	(19,290)
Contract assets	(66,451)	77,791
Prepaid expenses and other current assets	(7,719)	7,381
Deferred revenue, current	14,691	(12,810)
Deferred revenue, long-term		0
Deferred taxes, net	(27,195)	20,034
Retained earnings (accumulated deficit)	$ (79,056)	$ 58,658

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	Dec. 31, 2018	Jan. 01, 2018	Dec. 31, 2017
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Accounts receivable, net	$ 465,264		$ 492,560
Contract assets	66,451		0
Prepaid expenses and other current assets	142,455		106,455
Contract assets - long-term	71,879		0
Deferred revenue, current	466,797		478,574
Deferred taxes, net	58,470		23,258
Retained earnings (accumulated deficit)	132,842		$ (338,150)
ASC 606
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Accounts receivable, net		$ 473,270
Contract assets		77,791
Prepaid expenses and other current assets		113,836
Deferred revenue, current		465,764
Deferred taxes, net		43,292
Retained earnings (accumulated deficit)		(279,492)
ASC 606 \| Adjustments Due to ASC 606 [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Accounts receivable, net	54,489	(19,290)
Contract assets	(66,451)	77,791
Prepaid expenses and other current assets	(7,719)	7,381
Contract assets - long-term	(71,879)
Deferred revenue, current	14,691	(12,810)
Deferred taxes, net	(27,195)	20,034
Retained earnings (accumulated deficit)	(79,056)	$ 58,658
Pro forma Under ASC 605 [Member] \| ASC 606
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Accounts receivable, net	519,753
Contract assets	0
Prepaid expenses and other current assets	134,736
Contract assets - long-term	0
Deferred revenue, current	481,488
Deferred taxes, net	31,275
Retained earnings (accumulated deficit)	$ 53,786

Revenue from Contracts with Customers - Schedule of Comparison Between Reported Statements to Pro-forma Amounts in Effect of Previous Guidance - Statement of Operations (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Total revenue	$ 442,346	$ 432,430	$ 441,464	$ 433,722	$ 436,411	$ 368,091	$ 350,150	$ 343,056	$ 1,749,962	$ 1,497,708	$ 1,386,069
Gross profit	188,159	177,952	173,767	184,665	176,203	162,248	150,220	144,128	724,543	632,799	601,299
Selling, general and administrative expenses	99,992	108,125	122,913	119,937	123,113	93,790	91,033	92,752	450,967	400,688	334,521
Loss from operations	(26,443)	186	(60,094)	(6,701)	(21,259)	18,157	13,237	2,349	(93,052)	12,484	67,710
Income (loss) from continuing operations before income taxes	(40,044)	(13,778)	91,822	(24,862)	(32,578)	(12,030)	(139,882)	(5,547)	13,138	(190,037)	31,560
Income tax (provision) benefit	5,449	1,637	(7,256)	(299)	9,973	(1,962)	(1,263)	(1,234)	(469)	5,514	(309)
Income (loss) from continuing operations	(34,595)	(12,141)	84,566	(25,161)	(22,605)	(13,992)	(141,145)	(6,781)	12,669	(184,523)	31,251
Net income attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ 374,781	$ (35,991)	$ 64,824	$ (39,874)	$ 5,818	$ (28,587)	$ (153,710)	$ (19,980)	$ 363,740	$ (196,459)	$ (25,652)
Earnings per share - basic attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ 2.17	$ (0.20)	$ 0.36	$ (0.22)	$ 0.03	$ (0.16)	$ (0.85)	$ (0.11)	$ 2.07	$ (1.09)	$ (0.14)
Earnings per share - diluted attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ 2.14	$ (0.20)	$ 0.36	$ (0.22)	$ 0.03	$ (0.16)	$ (0.85)	$ (0.11)	$ 2.04	$ (1.09)	$ (0.14)
ASC 606 \| Adjustments Due to ASC 606 [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Gross profit									$ (26,906)
Selling, general and administrative expenses									(176)
Loss from operations									(26,730)
Income (loss) from continuing operations before income taxes									(27,559)
Income tax (provision) benefit									7,160
Income (loss) from continuing operations									(20,399)
Net income attributable to Allscripts Healthcare Solutions, Inc. stockholders									$ (20,399)
Earnings per share - basic attributable to Allscripts Healthcare Solutions, Inc. stockholders									$ (0.12)
Earnings per share - diluted attributable to Allscripts Healthcare Solutions, Inc. stockholders									$ (0.11)
Software delivery, Support and Maintenance [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Total revenue									$ 1,128,263	$ 958,187	$ 899,299
Software delivery, Support and Maintenance [Member] \| ASC 606 \| Adjustments Due to ASC 606 [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Total revenue									(21,780)
Client services [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Total revenue									621,699	$ 539,521	$ 486,770
Client services [Member] \| ASC 606 \| Adjustments Due to ASC 606 [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Total revenue									(6,185)
Pro forma Under ASC 605 [Member] \| ASC 606
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Gross profit									697,637
Selling, general and administrative expenses									450,791
Loss from operations									(119,782)
Income (loss) from continuing operations before income taxes									(14,421)
Income tax (provision) benefit									6,691
Income (loss) from continuing operations									(7,730)
Net income attributable to Allscripts Healthcare Solutions, Inc. stockholders									$ 343,341
Earnings per share - basic attributable to Allscripts Healthcare Solutions, Inc. stockholders									$ 1.95
Earnings per share - diluted attributable to Allscripts Healthcare Solutions, Inc. stockholders									$ 1.93
Pro forma Under ASC 605 [Member] \| Software delivery, Support and Maintenance [Member] \| ASC 606
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Total revenue									$ 1,106,483
Pro forma Under ASC 605 [Member] \| Client services [Member] \| ASC 606
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Total revenue									$ 615,514

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								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenue From Contract With Customer [Abstract]
Revenue related to deferred revenue balance at beginning of period	$ 141,127	$ 153,151	$ 196,163	$ 181,398
Revenue related to new performance obligations satisfied during the period	237,963	225,641	180,001	200,232
Revenue recognized under "right-to-invoice" expedient	60,593	51,288	62,533	49,403
Reimbursed travel expenses, shipping and other revenue	2,663	2,350	2,767	2,689
Total revenue	$ 442,346	$ 432,430	$ 441,464	$ 433,722	$ 436,411	$ 368,091	$ 350,150	$ 343,056	$ 1,749,962	$ 1,497,708	$ 1,386,069

Revenue from Contracts with Customers - Summary of Revenue by Type and Nature of Revenue Stream by Reportable Segments (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disaggregation Of Revenue [Line Items]
Total revenue	$ 442,346	$ 432,430	$ 441,464	$ 433,722	$ 436,411	$ 368,091	$ 350,150	$ 343,056	$ 1,749,962	$ 1,497,708	$ 1,386,069
Unallocated [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									(6,731)	(13,131)	25,479
Clinical and Financial Solutions [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									1,565,987	1,337,030	1,183,196
Population Health [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									190,706	173,809	177,394
Software delivery, Support and Maintenance [Member]
Disaggregation Of Revenue [Line Items]
Recurring revenue									967,990	802,080	752,084
Non-recurring revenue									160,273	156,107	147,215
Total revenue									1,128,263	958,187	899,299
Software delivery, Support and Maintenance [Member] \| Unallocated [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									1,844	(10,439)	23,088
Software delivery, Support and Maintenance [Member] \| Clinical and Financial Solutions [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									958,144	808,611	710,679
Software delivery, Support and Maintenance [Member] \| Population Health [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									168,275	160,015	165,532
Client services [Member]
Disaggregation Of Revenue [Line Items]
Recurring revenue									443,752	374,640	324,635
Non-recurring revenue									177,947	164,881	162,135
Total revenue									621,699	539,521	486,770
Client services [Member] \| Unallocated [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									(8,575)	(2,692)	2,391
Client services [Member] \| Clinical and Financial Solutions [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									607,843	528,419	472,517
Client services [Member] \| Population Health [Member] \| Operating Segments [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									$ 22,431	$ 13,794	$ 11,862

Business Combinations and Other Investments - Acquisition of Health Grid - Additional Information (Detail) - USD ($)		12 Months Ended
	May 18, 2018	Dec. 31, 2018	Feb. 13, 2018
Business Acquisition [Line Items]
Goodwill expected to be tax deductible		$ 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		500,000
Health Grid [Member] \| Level 3 [Member]
Business Acquisition [Line Items]
Potential earnout payments		23,900,000
Potential earnout payments, fair value		$ 23,900,000
Health Grid [Member] \| Maximum [Member]
Business Acquisition [Line Items]
Potential earnout payments	50,000,000
Remaining potential payments	$ 40,000,000

Schedule of Consideration Transaction (Detail) - USD ($) $ in Thousands					12 Months Ended
	May 18, 2018	Feb. 13, 2018	Oct. 02, 2017	Aug. 25, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Health Grid [Member]
Business Acquisition [Line Items]
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
Aggregate purchase price	110,000
Add: Closing cash	1,783
Total consideration paid	$ 95,924
Practice Fusion, Inc. [Member]
Business Acquisition [Line Items]
Aggregate purchase price		$ 100,000
Add: Net working capital surplus		373
Less: Adjustment for assumed indebtedness		(1,684)
Add: Closing cash		14,951
Total consideration paid		$ 113,640
NantHealth, Inc. [Member]
Business Acquisition [Line Items]
Aggregate purchase price				$ 1,742
Add: Final net working capital surplus				1,022
Add: NantHealth common stock				42,750	$ 0	$ 42,750	$ 0
Less: Value assigned to modification of existing commercial agreement with NantHealth				(22,900)
Add: Closing cash				21
Total consideration paid				$ 22,614
EIS Business [Member]
Business Acquisition [Line Items]
Aggregate purchase price			$ 169,497
Add: Final net working capital surplus			1,331
Less: Assumption of restructuring indebtedness			(16,834)
Add: Closing cash			1,068
Total consideration paid			$ 185,000

Assets Acquired and Liabilities Assumed (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	May 18, 2018	Feb. 13, 2018	Dec. 31, 2017	Oct. 02, 2017	Aug. 25, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Goodwill	$ 1,373,744			$ 1,292,747			$ 1,248,712
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			67,100
Goodwill			35,092
Other assets			42
Accounts payable and accrued expenses			(7,378)
Deferred revenue			(2,400)
Long-term deferred tax liability			(8,853)
Other liabilities			(815)
Net assets acquired			$ 113,640
NantHealth, Inc. [Member]
Business Acquisition [Line Items]
Cash and cash equivalents						$ 21
Accounts receivable, net						2,069
Prepaid expenses and other assets						1,735
Fixed assets						3,401
Intangible assets						12,400
Goodwill						13,466
Other assets						204
Accounts payable and accrued expenses						(1,477)
Deferred revenue						(9,205)
Net assets acquired						$ 22,614
EIS Business [Member]
Business Acquisition [Line Items]
Cash and cash equivalents					$ 1,068
Accounts receivable, net					72,996
Prepaid expenses and other assets					19,358
Fixed assets					9,808
Intangible assets					143,000
Goodwill					61,337
Other assets					1,601
Accounts payable and accrued expenses					(34,285)
Deferred revenue					(102,523)
Other liabilities					(2,863)
Net assets acquired					$ 169,497

Acquired Intangible Assets Amortization (Detail) - USD ($) $ in Thousands	May 18, 2018	Feb. 13, 2018	Oct. 02, 2017	Aug. 25, 2017
Health Grid [Member]
Business Acquisition [Line Items]
Intangible assets	$ 41,000
Health Grid [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets, fair value	$ 28,000
Description	15 years
Health Grid [Member] \| Technology [Member]
Business Acquisition [Line Items]
Intangible assets, fair value	$ 13,000
Description	8 years
Practice Fusion, Inc. [Member]
Business Acquisition [Line Items]
Intangible assets		$ 67,100
Practice Fusion, Inc. [Member] \| Technology [Member]
Business Acquisition [Line Items]
Intangible assets, fair value		$ 14,800
Description		8 years
Practice Fusion, Inc. [Member] \| Customer Relationships - Physician Practices [Member]
Business Acquisition [Line Items]
Intangible assets, fair value		$ 29,000
Description		15 years
Practice Fusion, Inc. [Member] \| Customer Relationships - Pharmaceutical Partners [Member]
Business Acquisition [Line Items]
Intangible assets, fair value		$ 19,400
Description		20 years
Practice Fusion, Inc. [Member] \| Tradenames [Member]
Business Acquisition [Line Items]
Intangible assets, fair value		$ 3,900
Description		10 years
NantHealth, Inc. [Member]
Business Acquisition [Line Items]
Intangible assets				$ 12,400
NantHealth, Inc. [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets, fair value				$ 9,200
Description				19 years
NantHealth, Inc. [Member] \| Technology [Member]
Business Acquisition [Line Items]
Intangible assets, fair value				$ 3,000
Description				5 years
NantHealth, Inc. [Member] \| Tradenames [Member]
Business Acquisition [Line Items]
Intangible assets, fair value				$ 200
Description				5 years
EIS Business [Member]
Business Acquisition [Line Items]
Intangible assets			$ 143,000
EIS Business [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets, fair value			$ 80,800
Description			10 years
EIS Business [Member] \| Technology [Member]
Business Acquisition [Line Items]
Intangible assets, fair value			$ 58,400
Description			7 years
EIS Business [Member] \| Tradenames [Member]
Business Acquisition [Line Items]
Intangible assets, fair value			$ 3,800
Description			7 years

Business Combinations and Other Investments - Acquisition of Practice Fusion, Inc - Additional Information (Detail) - USD ($)		12 Months Ended
	Feb. 13, 2018	Dec. 31, 2018
Business Acquisition [Line Items]
Goodwill expected to be tax deductible	$ 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		$ 1,200,000

Business Combinations and Other Investments - Netsmart LLC Divestiture - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended				12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Pre-tax gain (loss) on sale of business	$ 0	$ 0	$ 173,129	$ (871)	$ 172,258	$ 0	$ 0
Netsmart [Member]
Business Acquisition [Line Items]
Pre-tax gain (loss) on sale of business					500,500
Netsmart [Member] \| Class A Common Units [Member]
Business Acquisition [Line Items]
Consideration for sale	$ 566,600				$ 566,600

Business Combinations and Other Investments - Other Acquisitions and Divestitures - Additional Information (Detail) - USD ($)

3 Months Ended

12 Months Ended

Jun. 15, 2018

Apr. 02, 2018

Feb. 06, 2018

Dec. 31, 2018

Sep. 30, 2018

Jun. 30, 2018

Mar. 31, 2018

Dec. 31, 2018

Dec. 31, 2017

Dec. 31, 2016

Feb. 13, 2018

Acquisition of outstanding minority interest in third party

$ 6,900,000

Pre-tax gain (loss) on sale of business

$ 0

$ 173,129,000

$ (871,000)

$ 172,258,000

$ 0

Equity method investments

^[1]

10,667,000

4,258,000

Cash paid for business acquisitions

177,233,000

169,823,000

99,837,000

Goodwill

1,373,744,000

$ 1,292,747,000

$ 1,248,712,000

Goodwill expected to be tax deductible

$ 0

Strategic Sourcing Business [Member]

Effective date of divestiture

March 15, 2018

Payment to acquire additional interest in a new entity

$ 2,700,000

Minority interest percentage

35.70%

Equity method investments

$ 4,000,000

Initial pre-tax loss on sale of business

900,000

Additional pre-tax loss on sale of business

$ 4,700,000

Cloud-based Analytics Software Platform Provider [Member]

Cash paid for business acquisitions

Date of acquisition

Feb. 06, 2018

$ 8,000,000

Goodwill

6,600,000

Accounts receivable, net

800,000

Liabilities assumed, deferred revenue

600,000

Liabilities assumed, deferred tax liabilities net

500,000

Goodwill expected to be tax deductible

Cloud-based Analytics Software Platform Provider [Member] | Technology-Based Intangible Assets

Cloud-based Analytics Software Platform Provider [Member] | Customer Relationships [Member]

Intangible assets

1,100,000

Description

8 years

One Content Business [Member]

Intangible assets

$ 600,000

Description

1 year

Pre-tax gain (loss) on sale of business

Date of divestiture

Apr. 02, 2018

Total consideration paid

$ 260,000,000

$ 177,900,000

[1]	(1)Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

Business Combinations and Other Investments - Acquisition of the Patient/Provider Engagement Solutions Business from NantHealth, Inc. - Additional Information (Detail) - NantHealth, Inc. [Member] - USD ($) $ in Thousands		12 Months Ended
	Aug. 25, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Date of acquisition		Aug. 25, 2017
Number of shares as consideration for asset purchase agreement	15,000,000
Aggregate consideration with a fair value	$ 42,750	$ 0	$ 42,750	$ 0

Business Combinations and Other Investments - Acquisition of the Enterprise Information Solutions Business from McKesson Corporation - Additional Information (Detail) - EIS Business [Member] $ in Thousands		12 Months Ended
	Oct. 02, 2017 USD ($) Subsidiary	Dec. 31, 2017 USD ($)
Business Acquisition [Line Items]
Number of wholly owned subsidiaries in which outstanding equity interest acquired \| Subsidiary	2
Total consideration paid	$ 185,000
Selling, General and Administrative Expenses [Member]
Business Acquisition [Line Items]
Acquisition-related costs		$ 4,800

Pro forma Results (Detail) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2017 USD ($) $ / shares
HealthMEDX, LLC [Member]
Business Acquisition [Line Items]
Revenue	$ 6,268
Net loss	(4,393)
EIS Business [Member]
Business Acquisition [Line Items]
Revenue	77,046
Net loss	(15,160)
Combined Entity [Member]
Business Acquisition [Line Items]
Revenue	1,768,530
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$ (192,653)
Loss per share, basic and diluted \| $ / shares	$ (1.07)

Summary of Other Equity Investments Included in Other Assets (Detail)
$ in Thousands

12 Months Ended

Dec. 31, 2018

USD ($)

Investment

Dec. 31, 2017

USD ($)

Investments In Affiliates Subsidiaries Associates And Joint Ventures [Abstract]

Number of Investees | Investment

^[1]

Equity method investments, Original Cost

^[1]

$ 7,407

Equity method investments, Carrying Value

^[1]

$ 10,667

$ 4,258

Cost method investments, Number of Investees | Investment

Cost method investments, Original Cost

$ 37,874

Cost method investments, Carrying Value

$ 25,923

22,020

Total equity investments, Number of Investees | Investment

Total equity investments, Original Cost

$ 45,281

Total equity investments, Carrying Value

$ 36,590

$ 26,278

[1]	(1)Allscripts share of the earnings of our equity method investees is reported based on a one quarter lag.

Business Combinations and Other Investments - Other Acquisitions and Investments - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Total consideration for non marketable equity securities and convertible note	$ 16,934	$ 5,606	$ 21,185
2017 Convertible Note [Member]
Business Acquisition [Line Items]
Total consideration for non-marketable convertible note of a third party		2,600
Other Assets [Member] \| 2017 Convertible Note [Member]
Business Acquisition [Line Items]
Convertible note carrying value		2,600
Cost Method Equity Investments [Member] \| 2018 Convertible Note [Member]
Business Acquisition [Line Items]
Total consideration for non marketable equity securities and convertible note	1,800
Cost Method Equity Investments [Member] \| 2018 Business Acquisitions [Member]
Business Acquisition [Line Items]
Total consideration for non marketable equity securities and convertible note	11,700
Cost Method Equity Investments [Member] \| 2017 Business Acquisitions [Member]
Business Acquisition [Line Items]
Total consideration for non marketable equity securities and convertible note		2,800
Cost Method Equity Investments [Member] \| Other Assets [Member] \| 2018 Convertible Note [Member]
Business Acquisition [Line Items]
Carrying value of investments	13,500
Cost Method Equity Investments [Member] \| Other Assets [Member] \| 2017 Business Acquisitions [Member]
Business Acquisition [Line Items]
Carrying values of cost method investments	$ 3,500	$ 2,800

Business Combinations and Other Investments - Impairment of and Losses on Long-term Investments - Additional Information (Detail) - USD ($)	3 Months Ended								9 Months Ended	12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Impairment of long-term investments	$ 0	$ 0	$ 9,987,000	$ 5,500,000	$ 0	$ 20,700,000	$ 144,590,000	$ 0		$ 15,487,000	$ 165,290,000	$ 0
Other-than-temporary impairments							142,200,000			$ 0		$ 0
Available for sale marketable securities cost basis							$ 205,600,000
Loss on final disposition of securities						$ 20,700,000
Equity Securities [Member]
Business Acquisition [Line Items]
Other-than-temporary impairment charges on cost method equity investments									$ 2,100,000
Aggregate carrying value of cost method investments prior to impairment charges					$ 2,100,000						$ 2,100,000

Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
1.25% Cash Convertible Senior Notes [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Interest rate	1.25%
1.25% Call Option [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Interest rate	1.25%	1.25%
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Interest rate	1.25%
Health Grid [Member] \| Level 3 [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Outstanding contingent consideration value	$ 23.9

Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	$ 142,455	$ 106,455
Total assets	9,366	47,714
Total liabilities	35,819	54,813
Foreign exchange derivative assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	262	1,136
Contingent Consideration [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	10,528	1,950
Other liabilities	15,317	5,086
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	9,974	47,777
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
Level 1 [Member] \| Contingent Consideration [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
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 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets	262	1,136
Total liabilities	0	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	262	1,136
Level 2 [Member] \| Contingent Consideration [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
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 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total assets	9,104	46,578
Total liabilities	35,819	54,813
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
Level 3 [Member] \| Contingent Consideration [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	10,528	1,950
Other liabilities	15,317	5,086
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	9,974	47,777
1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	9,104	46,578
1.25% Call Option [Member] \| Level 1 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	0	0
1.25% Call Option [Member] \| Level 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	0	0
1.25% Call Option [Member] \| Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	$ 9,104	$ 46,578

Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Parenthetical) (Detail)	Dec. 31, 2018	Dec. 31, 2017
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%	1.25%

Summary of Changes in Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Contingent Consideration [Member]
Fair Value, Net Derivative Asset (Liability) and Contingent Consideration Measured on Recurring Basis, Unobservable Input Reconciliation [Roll Forward]
Beginning balance	$ 7,036	$ 5,285
Additions	24,551	1,923
Payments	(6,067)	(171)
Fair value adjustments	325	(1)
Ending balance	25,845	7,036
1.25% Cash Convertible Senior Notes [Member]
Fair Value, Net Derivative Asset (Liability) and Contingent Consideration Measured on Recurring Basis, Unobservable Input Reconciliation [Roll Forward]
Beginning balance	(1,199)	(579)
Additions	0	0
Payments	0	0
Fair value adjustments	329	(620)
Ending balance	$ (870)	$ (1,199)

Fixed Assets (Detail) - USD ($) $ in Thousands	12 Months Ended
Fixed Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 401,116	$ 380,694
Less: Accumulated depreciation and amortization	(279,203)	(245,277)
Fixed assets, net	121,913	135,417
Computer Equipment and Software [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 332,826	316,537
Computer Equipment and Software [Member] \| Minimum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	3 years
Computer Equipment and Software [Member] \| Maximum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	10 years
Facility Furniture, Fixtures and Equipment [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 21,300	23,923
Facility Furniture, Fixtures and Equipment [Member] \| Minimum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	5 years
Facility Furniture, Fixtures and Equipment [Member] \| Maximum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	7 years
Leasehold Improvements [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 37,555	33,031
Estimated useful life (in years)	Shorter of 7 years or life of lease
Assets Under Capital Leases [Member]
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 9,435	7,203
Less: Accumulated depreciation and amortization	$ (7,300)	$ (5,800)
Assets Under Capital Leases [Member] \| Minimum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	3 years
Assets Under Capital Leases [Member] \| Maximum [Member]
Property Plant And Equipment [Line Items]
Estimated useful life (in years)	5 years

Fixed Assets - Additional Information (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Property Plant And Equipment [Line Items]
Accumulated depreciation and amortization	$ 279,203	$ 245,277
Assets Under Capital Leases [Member]
Property Plant And Equipment [Line Items]
Accumulated depreciation and amortization	$ 7,300	$ 5,800

Depreciation and Amortization Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Property Plant And Equipment [Abstract]
Fixed assets depreciation and amortization expense, including capital leases	$ 47,567	$ 40,717	$ 34,314

Goodwill and Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	$ 1,242,642	$ 1,187,893
Accumulated Amortization	(863,561)	(804,320)
Intangible Assets, Net	379,081	383,573
Registered trademarks	52,000	52,000
Goodwill	1,373,744	1,292,747	$ 1,248,712
Total	1,425,744	1,344,747
Proprietary Technology [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	537,834	533,044
Accumulated Amortization	(401,093)	(365,828)
Intangible Assets, Net	136,741	167,216
Customer Contracts and Relationships [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Gross Carrying Amount	704,808	654,849
Accumulated Amortization	(462,468)	(438,492)
Intangible Assets, Net	$ 242,340	$ 216,357

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($)			3 Months Ended				12 Months Ended
	Jul. 02, 2018	Jan. 02, 2018	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Oct. 01, 2018	Jul. 01, 2018	Feb. 06, 2018	Jan. 01, 2018	Aug. 25, 2017
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill, impairments recorded	$ 0	$ 0	$ 13,466,000	$ 0	$ 0	$ 0	$ 13,466,000	$ 0	$ 0
Goodwill			1,373,744,000				1,373,744,000	1,292,747,000	1,248,712,000
Accumulated impairment losses associated with goodwill			13,500,000				13,500,000	0
Other additions							6,399,000	467,000
Goodwill reduction due to divestiture							32,306,000
Transfers							0
Strategic Sourcing 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
NantHealth, Inc. [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill, impairments recorded							13,500,000
Goodwill														$ 13,466,000
NantHealth, Inc. [Member] \| Proprietary Technology [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Intangible asset impairment charges							2,200,000
Cloud-based Analytics Software Platform Provider [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill												$ 6,600,000
Other additions							6,400,000
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
Hospital and Health Systems [Member] \| NantHealth, Inc. [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill										$ 516,800,000
Hospital and Health Systems [Member] \| NantHealth, Inc. [Member] \| Maximum [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Percentage of excess of fair value over carrying value										10.00%
NantHealth, Inc. [Member] \| Proprietary Technology [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Intangible asset impairment charges							2,200,000
Clinical and Financial Solutions [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Goodwill, impairments recorded							0
Goodwill			$ 930,362,000				930,362,000	861,615,000	$ 843,837,000
Other additions							6,399,000	$ 420,000
Goodwill reduction due to divestiture							0
Transfers							2,904,000
Clinical and Financial Solutions [Member] \| Strategic Sourcing Business [Member]
Schedule Of Goodwill And Intangible Assets [Line Items]
Transfers							$ 2,900,000

Changes in Carrying Amount of Goodwill (Detail) - USD ($)			3 Months Ended				12 Months Ended
	Jul. 02, 2018	Jan. 02, 2018	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Goodwill [Line Items]
Goodwill						$ 1,292,747,000	$ 1,292,747,000	$ 1,248,712,000
Additions arising from business acquisitions							95,444,000
Total increases due to measurement period adjustments:							32,165,000
Other additions							6,399,000	467,000
Total additions to goodwill							127,609,000	43,044,000
Divestitures							(32,306,000)
Foreign exchange translation							(840,000)	991,000
Goodwill impairment charge	$ 0	$ 0	$ (13,466,000)	$ 0	$ 0	0	(13,466,000)	0	$ 0
Transfers							0
Goodwill, net			1,373,744,000				1,373,744,000	1,292,747,000	1,248,712,000
NantHealth, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions								13,350,000
Total increases due to measurement period adjustments:							116,000
Goodwill impairment charge							(13,500,000)
Enterprise Information Solutions [Member]
Goodwill [Line Items]
Total increases due to measurement period adjustments:							32,049,000	29,227,000
Practice Fusion, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions							35,092,000
Health Grid [Member]
Goodwill [Line Items]
Additions arising from business acquisitions							53,953,000
Clinical and Financial Solutions [Member]
Goodwill [Line Items]
Goodwill						861,615,000	861,615,000	843,837,000
Additions arising from business acquisitions							41,491,000
Total increases due to measurement period adjustments:							25,192,000
Other additions							6,399,000	420,000
Total additions to goodwill							66,683,000	16,787,000
Divestitures							0
Foreign exchange translation							(840,000)	991,000
Goodwill impairment charge							0
Transfers							2,904,000
Goodwill, net			930,362,000				930,362,000	861,615,000	843,837,000
Clinical and Financial Solutions [Member] \| NantHealth, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions								0
Total increases due to measurement period adjustments:							0
Clinical and Financial Solutions [Member] \| Enterprise Information Solutions [Member]
Goodwill [Line Items]
Total increases due to measurement period adjustments:							25,192,000	16,367,000
Clinical and Financial Solutions [Member] \| Practice Fusion, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions							35,092,000
Clinical and Financial Solutions [Member] \| Health Grid [Member]
Goodwill [Line Items]
Additions arising from business acquisitions							0
Population Health [Member]
Goodwill [Line Items]
Goodwill						$ 431,132,000	431,132,000	404,875,000
Additions arising from business acquisitions							53,953,000
Total increases due to measurement period adjustments:							6,973,000
Other additions							0	47,000
Total additions to goodwill							60,926,000	26,257,000
Divestitures							(32,306,000)
Foreign exchange translation							0	0
Goodwill impairment charge							(13,466,000)
Transfers							(2,904,000)
Goodwill, net			$ 443,382,000				443,382,000	431,132,000	$ 404,875,000
Population Health [Member] \| NantHealth, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions								13,350,000
Total increases due to measurement period adjustments:							116,000
Population Health [Member] \| Enterprise Information Solutions [Member]
Goodwill [Line Items]
Total increases due to measurement period adjustments:							6,857,000	$ 12,860,000
Population Health [Member] \| Practice Fusion, Inc. [Member]
Goodwill [Line Items]
Additions arising from business acquisitions							0
Population Health [Member] \| Health Grid [Member]
Goodwill [Line Items]
Additions arising from business acquisitions							$ 53,953,000

Amortization Expense Related to Intangible Assets (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Finite Lived Intangible Assets [Line Items]
Amortization of software development and acquisition-related assets									$ 102,876	$ 84,725	$ 71,215
Amortization of intangible and acquisition-related assets	$ 6,957	$ 6,609	$ 6,382	$ 6,639	$ 6,005	$ 3,816	$ 3,745	$ 3,779	26,587	17,345	15,884
Total intangible amortization expense	$ 65,054				$ 50,482				65,054	50,482	46,335
Proprietary Technology [Member]
Finite Lived Intangible Assets [Line Items]
Amortization of software development and acquisition-related assets									$ 38,467	$ 33,137	$ 30,451

Estimated Future Amortization Expense for Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Goodwill And Intangible Assets Disclosure [Abstract]
2019	$ 63,010
2020	58,356
2021	52,928
2022	46,472
2023	30,272
Thereafter	128,043
Intangible Assets, Net	$ 379,081	$ 383,573

Asset Impairment Charges - Additional Information (Detail) - USD ($)			3 Months Ended								12 Months Ended
	Jul. 02, 2018	Jan. 02, 2018	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Asset Impairment Charges [Line Items]
Asset impairment charges			$ 28,091,000	$ 0	$ 30,075,000	$ 0					$ 58,166,000	$ 0	$ 4,650,000
Non-cash asset impairment charges related to disposal of fixed assets											2,100,000
Goodwill impairment charge	$ 0	$ 0	13,466,000	0	0	0					13,466,000	0	0
Other than temporary impairment charges on long-term Investments			$ 0	$ 0	$ 9,987,000	$ 5,500,000	$ 0	$ 20,700,000	$ 144,590,000	$ 0	15,487,000	$ 165,290,000	0
Other charges													400,000
Cost Method Equity Investments [Member]
Asset Impairment Charges [Line Items]
Asset impairment charges													2,100,000
NantHealth, Inc. [Member]
Asset Impairment Charges [Line Items]
Asset impairment charges											22,900,000
Unamortized value assigned to modification of existing commercial agreement with Nanhealth											20,700,000
Goodwill impairment charge											13,500,000
Proprietary Technology [Member] \| NantHealth, Inc. [Member]
Asset Impairment Charges [Line Items]
Write-down of intangible asset											2,200,000
Capitalized Software Development Projects [Member]
Asset Impairment Charges [Line Items]
Asset impairment charges											$ 33,200,000		$ 2,200,000

Summary of Non-Cash Asset Impairment Charges (Detail) - USD ($)			3 Months Ended								12 Months Ended
	Jul. 02, 2018	Jan. 02, 2018	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Asset Impairment Charges [Abstract]
Asset impairment charges			$ 28,091,000	$ 0	$ 30,075,000	$ 0					$ 58,166,000	$ 0	$ 4,650,000
Goodwill impairment charge	$ 0	$ 0	13,466,000	0	0	0					13,466,000	0	0
Impairment of long-term investments			$ 0	$ 0	$ 9,987,000	$ 5,500,000	$ 0	$ 20,700,000	$ 144,590,000	$ 0	$ 15,487,000	$ 165,290,000	$ 0

Debt Outstanding Excluding Capital Lease Obligations (Detail) - USD ($)
$ in Thousands

Dec. 31, 2018

Dec. 31, 2017

$ 695,748

$ 973,750

28,150

39,338

Principal Balance, Current

667,598

934,412

20,538

28,125

Unamortized Discount and Debt Issuance Costs, Current

479

438

Net Carrying Amount, Current

20,059

27,687

Principal Balance, Noncurrent

675,210

945,625

Unamortized Discount and Debt Issuance Costs, Noncurrent

27,671

38,900

Net Carrying Amount, Noncurrent

647,539

906,725

345,000

^[1]

345,000

22,112

35,978

Senior Secured Credit Facility [Member]

322,888

309,022

350,000

628,750

6,038

3,360

343,962

625,390

Other Debt [Member]

748

$ 748

$ 0

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

Interest Expense (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
Interest Expense (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Debt Instrument [Line Items]
Total interest expense	$ 13,989	$ 13,251	$ 11,979	$ 11,695	$ 11,594	$ 9,251	$ 8,279	$ 8,416	$ 50,914	$ 37,540	$ 29,478
Convertible Senior Notes and Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Interest expense									35,366	23,001	15,556
Amortization of discounts and debt issuance costs									15,548	14,539	13,922
Total interest expense									$ 50,914	$ 37,540	$ 29,478

Interest Expense Related to 1.25% Cash Convertible Senior Notes (Detail) - 1.25% Cash Convertible Senior Notes [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Debt Instrument [Line Items]
Coupon interest at 1.25%	$ 4,312	$ 4,312	$ 4,312
Amortization of discounts and debt issuance costs	13,867	13,208	12,585
Total interest expense related to the 1.25% Notes	$ 18,179	$ 17,520	$ 16,897

Debt - Additional Information (Detail)

1 Months Ended

12 Months Ended

Feb. 15, 2018

USD ($)

Jun. 18, 2013

USD ($)

$ / shares

Jun. 30, 2013

USD ($)

Dec. 31, 2018

USD ($)

$ / shares

Dec. 31, 2013

USD ($)

Dec. 31, 2017

USD ($)

Sep. 30, 2015

USD ($)

Maximum percentage of foreign subsidiary capital stock guaranteeing credit facility

65.00%

Payments for 1.25% Call Option

$ 695,748,000

$ 973,750,000

$ 82,800,000

Proceeds from issuance of warrants, net of issuance costs

51,200,000

Net cash payment for 1.25% Notes call spread overlay

$ 31,600,000

Senior Secured Revolving Facility [Member]

Initial margin for borrowings

1.00%

Credit facility borrowing capacity, amount available

899,200,000

Senior Secured Revolving Facility [Member] | Eurocurrency Rate [Member]

Initial margin for borrowings

2.00%

Senior Secured Credit Facility [Member]

Senior Secured Credit Facility [Member] | Minimum [Member]

$ 350,000,000

628,750,000

Senior Secured Credit Facility [Member] | Maximum [Member]

Interest coverage ratio

350.00%

Senior Secured Term Loan [Member]

Leverage ratio

425.00%

$ 350,000,000

Debt instrument, interest rate, effective percentage

$ 345,000,000

^[1]

$ 345,000,000

5.40%

Debt instrument convertible, principal amount

$ 345,000,000

Proceeds from debt

$ 305,100,000

Interest payment, terms

Interest on the 1.25% Notes is payable semiannually in arrears on January 1st and July 1st of each year

Debt, Maturity date

Jul. 01, 2020

$ 1,000

Convertible number of equity instrument

58.1869

Conversion price per common stock | $ / shares

$ 17.19

Repurchase percentage on principal

100.00%

Fair value liability of embedded cash conversion option

$ 82,800,000

Convertible debt instrument remaining discount amortization period

1 year 6 months

Interest rate

1.25%

Debt Instrument, fees and aggregate cost

8,400,000

Debt instrument capitalized amount

$ 8,300,000

Deferred charges capitalized amount outstanding

$ 1,800,000

Accrued and unpaid interest

$ 2,200,000

Payments for 1.25% Call Option

$ 82,800,000

1.25% Cash Convertible Senior Notes [Member] | Condition One [Member]

Threshold consecutive trading days

Threshold trading days

20 days

30 days

Debt instrument conversion price percentage

130.00%

1.25% Cash Convertible Senior Notes [Member] | Condition Two [Member]

Threshold consecutive trading days

Threshold trading days

5 days

5 days

Debt instrument conversion price percentage

98.00%

Debt instrument convertible, principal amount

$ 1,000

Senior Secured Term Loan [Member]

Credit facility, maximum borrowing capacity

$ 400,000,000

$ 250,000,000

Senior secured credit facilities term, years

5 years

Line of credit facility, frequency of payments

The Term Loan is repayable in quarterly installments, which commenced on June 30, 2018.

Senior Secured Revolving Facility [Member]

Credit facility, maximum borrowing capacity

$ 900,000,000

550,000,000

Senior secured credit facilities term, years

5 years

Credit facility, maximum borrowing capacity, foreign currencies

$ 100,000,000

Letter of Credit [Member]

Portion of facility available for issuance of letters of credit

50,000,000

Line of Credit [Member]

Portion of facility available for issuance of swingline loans

10,000,000

Senior Secured Credit Facility [Member]

Aggregate amount of additional credit facilities authorized

$ 600,000,000

$ 300,000,000

Second Amended Credit Agreement [Member] | Senior Secured Revolving Facility [Member]

Second Amended Credit Agreement [Member] | Senior Secured Credit Facility [Member]

$ 0

Letters of credit outstanding

$ 800,000

Second Amended Credit Agreement [Member] | Senior Secured Credit Facility [Member] | United States dollars [Member]

Debt instrument, interest rate, effective percentage

4.52%

Second Amended Credit Agreement [Member] | Senior Secured Term Loan [Member]

Second Amended Credit Agreement [Member] | Base Rate [Member] | Senior Secured Revolving Facility [Member] | Minimum [Member]

$ 350,000,000

Senior secured credit facility interest rate spread

0.50%

Second Amended Credit Agreement [Member] | Base Rate [Member] | Senior Secured Revolving Facility [Member] | Maximum [Member]

Senior secured credit facility interest rate spread

1.25%

Second Amended Credit Agreement [Member] | Eurocurrency Rate [Member] | Senior Secured Revolving Facility [Member] | Minimum [Member]

Senior secured credit facility interest rate spread

1.50%

Second Amended Credit Agreement [Member] | Eurocurrency Rate [Member] | Senior Secured Revolving Facility [Member] | Maximum [Member]

Senior secured credit facility interest rate spread

2.25%

Second Amended Credit Agreement [Member] | LIBOR Rate [Member] | Senior Secured Credit Facility [Member]

Senior secured credit facility interest rate spread

2.00%

2015 Credit Agreement [Member] | Senior Secured Credit Facility [Member] | Minimum [Member] | Covenant On Potential Acquisition [Member]

Consideration paid for acquisitions

$ 100,000,000

2015 Credit Agreement [Member] | Senior Secured Credit Facility [Member] | Maximum [Member] | Covenant On Potential Acquisition [Member]

2015 Credit Agreement [Member] | Base Rate [Member] | Senior Secured Revolving Facility [Member] | Minimum [Member]

Leverage ratio

450.00%

Senior secured credit facility interest rate spread

0.00%

2015 Credit Agreement [Member] | Base Rate [Member] | Senior Secured Revolving Facility [Member] | Maximum [Member]

Senior secured credit facility interest rate spread

1.25%

2015 Credit Agreement [Member] | Eurocurrency Rate [Member] | Senior Secured Revolving Facility [Member] | Minimum [Member]

Senior secured credit facility interest rate spread

1.00%

2015 Credit Agreement [Member] | Eurocurrency Rate [Member] | Senior Secured Revolving Facility [Member] | Maximum [Member]

Senior secured credit facility interest rate spread

2.25%

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

Summary of Future Debt Payments (Detail) - USD ($)
$ in Thousands

Dec. 31, 2018

Dec. 31, 2017

Total

$ 695,748

$ 973,750

20,538

372,710

30,000

37,500

235,000

Senior Secured Term Loan [Member]

Total

345,000

^[1]

345,000

2019

^[1]

2020

^[1]

345,000

^[1]

^[1]

^[1]

^[1]

350,000

20,000

27,500

30,000

37,500

235,000