0001564590-20-008173 | 10-K | XBRL Viewer | Allscripts Healthcare Solutions INC

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Business Segments

18. 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 2019, we realigned our reporting structure as a result of the divestiture of our investment in Netsmart on December 31, 2018, the evolution of the healthcare IT industry and our increased focus on the payer and life sciences market. As a result, we changed the presentation of our reportable segments to Provider and Veradigm. The new Provider segment is comprised of our core integrated clinical software applications, financial management and patient engagement solutions targeted at clients across the entire continuum of care. The new Veradigm segment primarily focuses on the payer and life sciences market. These changes to our reportable segments had no impact on operating segments. The segment disclosures below for the years ended December 31, 2018 and 2017 have been revised to our current presentation.

We sold all of our investment in Netsmart on December 31, 2018. 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 Provider reportable segment, except for acquisition-related deferred revenue adjustments, which are included in “Unallocated Amounts”. Refer to Note 17, “Discontinued Operations.”

As a result of the above changes, as of December 31, 2019, we had eight operating segments, which are aggregated into two reportable segments. The Provider reportable segment includes the Hospitals and Health Systems, Ambulatory, CarePort, FollowMyHealth^®, EPSi^TM, EIS-Classics and 2bPrecise 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, financial management and patient engagement 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 Veradigm reportable segment is comprised of the Veradigm business unit, which represents a separate operating segment. This reportable segment provides data-driven clinical insights with actionable tools for clinical workflow, research, analytics and media. Its solutions, targeted at key healthcare stakeholders, help improve the quality, efficiency and value of healthcare delivery.

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 and (ii) revenue and the associated cost from the resale of certain ancillary products, primarily hardware. We do not track our assets by segment.

	Year Ended December 31,
(In thousands)	2019			2018			2017
Revenue:
Provider	$	1,597,115		$	1,616,022		$	1,441,212
Veradigm		161,216			140,326			69,879
Unallocated Amounts		13,346			(6,386	)		(13,383	)
Total revenue	$	1,771,677		$	1,749,962		$	1,497,708

Gross profit:
Provider	$	672,206		$	710,063		$	674,112
Veradigm		104,896			100,708			43,817
Unallocated Amounts		(63,522	)		(86,228	)		(85,130	)
Total gross profit	$	713,580		$	724,543		$	632,799

Income (loss) from operations:
Provider	$	396,724		$	402,544		$	426,099
Veradigm		43,996			43,641			23,816
Unallocated Amounts		(465,176	)		(539,237	)		(437,431	)
Total income (loss) from operations	$	(24,456	)	$	(93,052	)	$	12,484

Supplemental Disclosures

12 Months Ended

Dec. 31, 2019

Supplemental Disclosures

19. Supplemental Disclosures

The majority of the restricted cash balance as of December 31, 2019 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)	2019		2018
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents	$	129,668	$	174,243
Restricted cash		7,871		10,552
Total cash, cash equivalents and restricted cash	$	137,539	$	184,795

	Year Ended December 31,
(In thousands)	2019		2018		2017
Cash paid during the period for:
Interest	$	19,604	$	28,888	$	21,183
Income taxes paid, net of tax refunds	$	42,972	$	10,108	$	6,675
Non-cash transactions:
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations	$	0	$	48,594	$	43,850
Exchange of NantHealth, Inc. common stock for net assets acquired of NantHealth provider/patient engagement solutions business including value assigned to commercial agreement	$	0	$	0	$	42,750
Obligations incurred to purchase capitalized software or enter into finance leases	$	0	$	1,501	$	1,897
Contributions of assets in exchange for equity interest	$	0	$	4,000	$	0
Issuance of treasury stock to commercial partner	$	701	$	1,121	$	334

Accrued expenses consist of the following:

	December 31,
(In thousands)	2019		2018
Royalties, certain third-party product costs and licenses	$	35,431	$	26,371
Practice Fusion settlement		145,000		0
Other		90,231		80,697
Total Accrued expenses	$	270,662	$	107,068

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.

Prepaids and other current assets consists of the following:

	December 31,
(In thousands)	2019		2018
Prepaid assets	$	146,036	$	140,352
Other current assets		1,954		2,103
Total Prepaid and other current assets	$	147,990	$	142,455

Other assets consist of the following:

	December 31,
(In thousands)	2019		2018
Fair value of 1.25% Call Option	$	84	$	9,104
Long-term deferred hosting fees		36,002		20,805
Long-term prepaid commissions		32,860		32,660
Investments in non-marketable securities		43,806		37,040
Long-term deposits and other assets		12,015		9,597
Total Other assets	$	124,767	$	109,206

Geographic Information

12 Months Ended

Dec. 31, 2019

Commitments And Contingencies Disclosure [Abstract]

Geographic Information

20. 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)	2019		2018		2017
United States	$	1,701,173	$	1,697,178	$	1,440,842
Canada		16,495		15,377		15,818
Other international		54,009		37,407		41,048
Total	$	1,771,677	$	1,749,962	$	1,497,708

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

	December 31,
(In thousands)	2019		2018
United States	$	78,122	$	111,836
India		5,321		4,231
Israel		3,240		3,830
Canada		51		60
Other international		1,605		1,956
Total	$	88,339	$	121,913

Contingencies

12 Months Ended

Dec. 31, 2019

Contingencies

21. 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, as appropriate, 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, except as set forth below with respected to the expected resolution of the Practice Fusion investigations, 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 additional legal proceedings were resolved against or settled by us in a reporting period for amounts in excess of our management’s expectations, our consolidated financial statements for that and subsequent reporting periods 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. In January 2020, the parties stipulated to a voluntary dismissal of the case with prejudice, with each side bearing its own costs and fees. The matter is now resolved.

The Enterprise Information Solutions business (the “EIS Business”) acquired from McKesson Corporation (“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.

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 June 2019, Practice Fusion received from the U.S. Department of Justice (the “DOJ”) seven additional requests for documents and information through four additional CIDs and three Health Insurance Portability and Accountability Act (“HIPAA”) subpoenas. The document and information requests received by Practice Fusion related to both the certification Practice Fusion obtained in connection with the U.S. Department of Health and Human Services’ Electronic Health Record Incentive Program and Practice Fusion’s compliance with the Anti-Kickback Statute (“AKS”) and HIPAA as it relates to certain business practices engaged in by Practice Fusion. In March 2019, Practice Fusion received a grand jury subpoena in connection with a criminal investigation related to Practice Fusion’s compliance with the AKS. On August 6, 2019, Practice Fusion reached an agreement in principle with the DOJ to resolve all of the DOJ’s outstanding civil and criminal investigations, including the investigation by the U.S. Attorney’s Office for the District of Vermont, and we announced that on January 27, 2020, Practice Fusion entered into the Settlement Agreements resolving the investigations conducted by the DOJ and the U.S. Attorney’s Office. See risk factor entitled “The failure by Practice Fusion to comply with the terms of its settlement agreements with the DOJ could have a material and adverse impact on our business, results of operations and financial condition, and, even if Practice Fusion complies with those settlement agreements, the costs and burdens of compliance could be significant, and we may face additional investigations and proceedings from other governmental entities or third parties related to the same or similar conduct underlying the agreements with the DOJ.” The Settlement Agreements require Practice Fusion to pay a criminal fine of $25.3 million and a forfeiture payment of $959,700 and a civil settlement of $118.6 million, which includes $5.2 million designated for the state Medicaid program expenditures. The terms of Settlement Agreements resolved, among other things, allegations that Practice Fusion, long before its acquisition by Allscripts and concerning conduct about which Allscripts was unaware at the time of the acquisition, violated the AKS through the manner by which a sponsored Clinical Decision Support arrangement was sold to an opioid manufacturer and other AKS allegations made by the DOJ against Practice Fusion as well as False Claims Act allegations pertaining to Meaningful Use payments the federal government made to users of Practice Fusion’s EHR system. The settlement amount is included in Other income (loss), net within the consolidated statements of operations and Accrued expenses within the consolidated balance sheets for the year ended December 31, 2019.

Quarterly Financial Information (Unaudited)

12 Months Ended

Dec. 31, 2019

Quarterly Financial Information Disclosure [Abstract]

Quarterly Financial Information (Unaudited)

22. 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)	2019			2019 ⁽²⁾			2019 ⁽¹⁾			2019
Revenue	$	450,984		$	444,184		$	444,460		$	432,049
Cost of revenue		270,923			268,882			260,338			257,954
Gross profit		180,061			175,302			184,122			174,095
Selling, general and administrative expenses		112,835			101,152			105,542			100,245
Research and development		62,912			63,873			63,414			64,310
Asset impairment charges		6,800			248			3,691			98
Goodwill impairment charge		25,700			0			0			0
Amortization of intangible and acquisition-related assets		6,840			6,847			6,732			6,797
(Loss) income from operations		(35,026	)		3,182			4,743			2,645
Interest expense		(11,725	)		(10,839	)		(10,424	)		(10,184	)
Other income (loss), net		4,798			781			(144,994	)		513
(Impairment) recovery on long-term investments		(1,696	)		0			0			1,045
Equity in net income (loss) of unconsolidated investments		125			386			218			(64	)
Loss from continuing operations before income taxes		(43,524	)		(6,490	)		(150,457	)		(6,045	)
Income tax benefit (provision)		24,554			765			527			(1,932	)
Net loss		(18,970	)		(5,725	)		(149,930	)		(7,977	)
Net loss attributable to non-controlling interest		0			0			0			424
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(18,970	)	$	(5,725	)	$	(149,930	)	$	(7,553	)

Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per share: ⁽⁵⁾
Basic
Continuing operations	$	(0.12	)	$	(0.03	)	$	(0.90	)	$	(0.04	)
Discontinued operations	$	0.00		$	0.00		$	0.00		$	0.00
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$	(0.12	)	$	(0.03	)	$	(0.90	)	$	(0.04	)

Diluted
Continuing operations	$	(0.12	)	$	(0.03	)	$	(0.90	)	$	(0.04	)
Discontinued operations	$	0.00		$	0.00		$	0.00		$	0.00
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$	(0.12	)	$	(0.03	)	$	(0.90	)	$	(0.04	)

	Quarter Ended
	December 31,			September 30,			June 30,			March 31,
(In thousands, except per share amounts)	2018			2018			2018 ⁽⁴⁾			2018 ⁽³⁾
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 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	)
Net loss attributable to non-controlling interest		1,033			4			2,700			790
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: ⁽⁵⁾
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	)

⁽¹⁾	Results of operations for the quarter include the results of operations of a third party engaged in a specialty prescription drug platform since June 10, 2019.

⁽²⁾	Results of operations for the quarter include the results of operations of Pinnacle and Diabetes and Collaborative Registries since July 2, 2019.

⁽³⁾	Results of operations for the quarter include the results of operations of Practice Fusion since February 13, 2018.

⁽⁴⁾	Results of operations for the quarter include the results of operations of Health Grid since May 18, 2018.

⁽⁵⁾	The sum of the quarterly per share amounts may not equal per share amounts reported for year to date periods. This is due to changes in the number of weighted-average shares outstanding and the effects of rounding for each period.

Schedule II-Valuation and Qualifying Accounts

12 Months Ended

Dec. 31, 2019

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, 2019	$	50,406		8,788		(6,029	)		(8,221	)	$	44,944
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

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, 2019

Accounting Policies [Abstract]

Principles of Consolidation

Use of Estimates

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)	2019			2018
Software development costs	$	428,641		$	317,637
Less: accumulated amortization		(184,712	)		(107,977	)
Software development costs, net	$	243,929		$	209,660

	Year Ended December 31,
(In thousands)	2019		2018		2017
Capitalized software development costs	$	113,836	$	113,308	$	94,740
Write-offs and divestitures of capitalized software development costs	$	0	$	34,083	$	0
Amortization of capitalized software development costs	$	79,567	$	64,409	$	51,589

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)	2019		2018		2017
Company contributions to employee benefit plans	$	24,782	$	29,393	$	18,861

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.

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

Basis of Presentation and Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2019

Accounting Policies [Abstract]

Unamortized Balances of Capitalized Software

The unamortized balances of capitalized software were as follows:

	December 31,
(In thousands)	2019			2018
Software development costs	$	428,641		$	317,637
Less: accumulated amortization		(184,712	)		(107,977	)
Software development costs, net	$	243,929		$	209,660

Capitalized Software Development Costs, Write Offs and Amortization of Capitalized Software Development Costs

	Year Ended December 31,
(In thousands)	2019		2018		2017
Capitalized software development costs	$	113,836	$	113,308	$	94,740
Write-offs and divestitures of capitalized software development costs	$	0	$	34,083	$	0
Amortization of capitalized software development costs	$	79,567	$	64,409	$	51,589

Company Contributions to Employee Benefit Plan

	Year Ended December 31,
(In thousands)	2019		2018		2017
Company contributions to employee benefit plans	$	24,782	$	29,393	$	18,861

Revenue from Contracts with Customers (Tables)

12 Months Ended

Dec. 31, 2019

Summary of Revenue Recognized on Various Performance Obligations and Elected Accounting Expedients

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

(In thousands)	Three Months Ended March 31, 2019		Three Months Ended June 30, 2019		Three Months Ended September 30, 2019		Three Months Ended December 31, 2019
Revenue related to deferred revenue balance at beginning of period	$	126,184	$	146,150	$	151,543	$	171,799
Revenue related to new performance obligations satisfied during the period		248,221		233,696		228,927		216,072
Revenue recognized under "right-to-invoice" expedient		55,923		62,245		61,814		60,826
Reimbursed travel expenses, shipping and other revenue		1,721		2,369		1,900		2,287
Total revenue	$	432,049	$	444,460	$	444,184	$	450,984

(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)	2019		2018		2017
Revenue:
Recurring revenue	$	1,395,869	$	1,411,742	$	1,176,720
Non-recurring revenue		375,808		338,220		320,988
Total revenue	$	1,771,677	$	1,749,962	$	1,497,708

Revenue by Segment [Member]

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

	Year Ended December 31, 2019
(In thousands)	Provider		Veradigm		Unallocated		Total
Software delivery, support and maintenance	$	965,925	$	148,352	$	12,209	$	1,126,486
Client services		631,190		12,864		1,137		645,191
Total revenue	$	1,597,115	$	161,216	$	13,346	$	1,771,677

	Year Ended December 31, 2018
(In thousands)	Provider		Veradigm		Unallocated			Total
Software delivery, support and maintenance	$	995,193	$	130,945	$	2,125		$	1,128,263
Client services		620,829		9,381		(8,511	)		621,699
Total revenue	$	1,616,022	$	140,326	$	(6,386	)	$	1,749,962

	Year Ended December 31, 2017
(In thousands)	Provider		Veradigm		Unallocated			Total
Software delivery, support and maintenance	$	904,391	$	64,360	$	(10,564	)	$	958,187
Client services		536,821		5,519		(2,819	)		539,521
Total revenue	$	1,441,212	$	69,879	$	(13,383	)	$	1,497,708

Leases (Tables)

12 Months Ended

Dec. 31, 2019

Lessee Disclosure [Abstract]

Summary of Total Costs Associated with Leased Assets

Total costs associated with leased assets are as follows:

(In thousands)	Year Ended December 31, 2019
Operating lease cost ⁽¹⁾	$	27,962
Less: Sublease income		(3,265	)
Total operating lease costs	$	24,697
Finance lease costs:
Amortization of right-of-use assets ⁽²⁾	$	157
Interest on lease liability ⁽³⁾		9
Total finance lease costs	$	166

⁽¹⁾	^{Operating lease costs are recognized on a straight-line basis and are included in Selling, general and administrative expenses within the consolidated statement of operations.}

⁽²⁾	Amortization of finance right-of-use assets is recognized on a straight-line basis and is included in in Selling, general and administrative expenses within the consolidated statement of operations.

⁽³⁾	Interest on finance lease liabilities is recorded as Interest expense within the consolidated statement of operations.

Supplemental Information for Operating and Finance Leases

Supplemental information for operating and finance leases is as follows:

(In thousands)	Year Ended December 31, 2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	30,039
Operating cash flows from finance leases	$	9
Financing cash flows from finance leases	$	158
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	143,602
Finance leases	$	263

Summary of Balance Sheet Location and Balances for Operating and Finance Leases

(In thousands, except lease term and discount rate)	December 31, 2019
Operating leases:
Right-of-use assets - operating leases	$	98,020
Current operating lease liabilities	$	23,137
Long-term operating lease liabilities	$	95,162

Finance leases:
Fixed assets, gross	$	524
Less: Accumulated depreciation		(392	)
Fixed assets, net	$	132

Current finance lease liabilities ⁽¹⁾	$	82
Long-term finance lease liabilities ⁽²⁾	$	45

Weighted average remaining lease term (in years)
Operating leases		6
Finance leases		2

Weighted average discount rate
Operating leases		4.4	%
Finance leases		5.1	%

⁽¹⁾	Current finance lease liabilities are included in Accrued expenses within the consolidated balance sheets.

⁽²⁾	Long-term finance lease liabilities are included in Other liabilities within the consolidated balance sheets.

Summary of Future Maturities of Lease and Non-Lease Components

	December 31, 2019
(In thousands)	Operating Leases			Finance Leases
2020	$	27,647		$	85
2021		23,277			40
2022		21,640			7
2023		19,497			0
2024		13,862			0
Thereafter		28,580			0
Total lease liabilities		134,503			132
Less: Amount representing interest		(16,204	)		(5	)
Less: Short-term lease liabilities		(23,137	)		(82	)
Total long-term lease liabilities	$	95,162		$	45

Business Combinations and Other Investments (Tables)

12 Months Ended

Dec. 31, 2019

Other Equity and Cost Method Investments [Member]

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, 2019		Cost		December 31, 2019		December 31, 2018
Equity method investments ⁽¹⁾		5	$	7,407	$	11,332	$	10,667
Cost less impairment		9		43,874		32,462		25,923
Total long-term equity investments		14	$	51,281	$	43,794	$	36,590

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

Health Grid [Member]

Schedule of Consideration Funded by Sources of Funds

The consideration paid for Health Grid is shown below:

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

Assets Acquired and Liabilities Assumed

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

Acquired Intangible Assets Amortization

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

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

Practice Fusion, Inc. [Member]

Schedule of Consideration Funded by Sources of Funds

The consideration paid for Practice Fusion is shown below:

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

Assets Acquired and Liabilities Assumed

	(In thousands)
Cash and cash equivalents	$	14,951
Accounts receivable, net		13,328
Prepaid expenses and other current assets		809
Fixed assets		1,764
Intangible assets		67,100
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

Acquired Intangible Assets Amortization

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

	Useful Life	Fair Value
Description	(In years)	(In thousands)
Customer Relationships - Physician Practices	15	$	29,000
Customer Relationships - Pharmaceutical Partners	20		19,400
Technology	8		14,800
Tradenames	10		3,900
		$	67,100

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2019

Fair Value Disclosures [Abstract]

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

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

	Balance Sheet	December 31, 2019								December 31, 2018
(In thousands)	Classifications	Level 1		Level 2		Level 3		Total		Level 1		Level 2		Level 3		Total
Foreign exchange derivative assets	Prepaid expenses and other current assets	$	0	$	0	$	0	$	0	$	0	$	262	$	0	$	262
1.25% Call Option	Other assets		0		0		84		84		0		0		9,104		9,104
Total assets		$	0	$	0	$	84	$	84	$	0	$	262	$	9,104	$	9,366

Contingent consideration - current	Accrued expenses	$	0	$	0	$	17,116	$	17,116	$	0	$	0	$	10,528	$	10,528
Contingent consideration - long-term	Other liabilities		0		0		2,415		2,415		0		0		15,317		15,317
1.25% Embedded cash conversion option	Other liabilities		0		0		185		185		0		0		9,974		9,974
Total liabilities		$	0	$	0	$	19,716	$	19,716	$	0	$	0	$	35,819	$	35,819

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, 2019 are summarized as follows:

(In thousands)	Contingent Consideration			1.25% Notes Call Spread Overlay
Balance at December 31, 2017	$	7,036		$	(1,199	)
Additions		24,551			0
Payments/write-downs		(6,067	)		0
Fair value adjustments		325			329
Balance at December 31, 2018	$	25,845		$	(870	)
Additions		12,144			0
Payments/write-downs ⁽¹⁾		(18,900	)		0
Fair value adjustments		442			769
Balance at December 31, 2019	$	19,531		$	(101	)

⁽¹⁾	^{Payments and write-downs for the year-ended December 31, 2019 primarily consisted of $10.0 million payment for the Health Grid earnout and $5.0 million write-down related to the Pulse8 earnout.}

Fixed Assets (Tables)

12 Months Ended

Dec. 31, 2019

Property Plant And Equipment [Abstract]

Fixed Assets

Fixed assets consist of the following:

	Estimated	December 31,			December 31,
(Dollar amounts in thousands)	Useful Life	2019			2018
Computer equipment and software	3 to 10 years	$	344,127		$	332,826
Facility furniture, fixtures and equipment	5 to 7 years		24,704			21,300
Leasehold improvements	Shorter of 7 years or life of lease		39,335			37,555
Assets under finance leases	1 to 3 years		524			9,435
Fixed assets, gross			408,690			401,116
Less: Accumulated depreciation and amortization			(320,351	)		(279,203	)
Fixed assets, net		$	88,339		$	121,913

Depreciation and Amortization Expense

	Year Ended December 31,
(In thousands)	2019		2018		2017
Fixed assets depreciation and amortization expense, including finance leases	$	47,419	$	47,567	$	40,717

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2019

Goodwill And Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

Goodwill and intangible assets consist of the following:

	December 31 2019							December 31, 2018
	Gross							Gross
	Carrying		Accumulated			Intangible		Carrying		Accumulated			Intangible
(In thousands)	Amount		Amortization			Assets, Net		Amount		Amortization			Assets, Net
Intangibles subject to amortization:
Proprietary technology	$	546,373	$	(437,640	)	$	108,733	$	537,834	$	(401,093	)	$	136,741
Customer contracts and relationships		702,034		(488,625	)		213,409		704,808		(462,468	)		242,340
Total	$	1,248,407	$	(926,265	)	$	322,142	$	1,242,642	$	(863,561	)	$	379,081

Intangibles not subject to amortization:
Registered trademarks						$	52,000						$	52,000
Goodwill							1,362,017							1,373,744
Total						$	1,414,017						$	1,425,744

Changes in Carrying Amount of Goodwill

Changes in the carrying amounts of goodwill by reportable segment for the years ended December 31, 2019 and 2018 were as follows:

(In thousands)	Provider			Veradigm		Total
Balance as of December 31, 2017	$	1,214,979		$	77,768	$	1,292,747
Additions from the Practice Fusion acquisition		0			35,092		35,092
Additions from the Health Grid acquisition		53,953			0		53,953
Additions from other acquisitions		0			6,604		6,604
Total arising from business acquisitions		53,953			41,696		95,649
Changes due to measurement period adjustments related to prior year acquisitions:
NantHealth provider/patient solutions business		116			0		116
Enterprise Information Solutions business		32,049			0		32,049
Other acquisitions		(205	)		0		(205	)
Total increases due to measurement period adjustments:		31,960			0		31,960
Total additions to goodwill		85,913			41,696		127,609
Divestitures		(32,306	)		0		(32,306	)
Goodwill impairment charge		(13,466	)		0		(13,466	)
Foreign exchange translation		(840	)		0		(840	)
Balance as of December 31, 2018	$	1,254,280		$	119,464	$	1,373,744
Additions		0			13,684		13,684
Goodwill impairment charge		(25,700	)		0		(25,700	)
Foreign exchange translation		289			0		289
Balance as of December 31, 2019	$	1,228,869		$	133,148	$	1,362,017

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)	2019		2018		2017
Proprietary technology amortization included in cost of revenue	$	36,472	$	38,467	$	33,137
Intangible amortization included in operating expenses		27,216		26,587		17,345
Total intangible amortization expense	$	63,688	$	65,054	$	50,482

Future Amortization Expense for Intangible Assets

Future amortization expense for the intangible assets as of December 31, 2019, based on foreign currency exchange rates in effect as of such date, is as follows:


Year Ended December 31,	(In thousands)
2020	$	59,226
2021		53,808
2022		47,407
2023		31,222
2024		26,803
Thereafter		103,676
Total	$	322,142

Asset Impairment Charges (Tables)

12 Months Ended

Dec. 31, 2019

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)	2019		2018		2017
Asset impairment charges	$	10,837	$	58,166	$	0
Goodwill impairment charge	$	25,700	$	13,466	$	0
Impairment of long-term investments	$	651	$	15,487	$	165,290

Debt (Tables)

12 Months Ended

Dec. 31, 2019

Debt Instrument [Line Items]

Debt Outstanding Excluding Fiance Lease Obligations

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

	December 31, 2019						December 31, 2018
(In thousands)	Principal Balance		Unamortized Discount and Debt Issuance Costs		Net Carrying Amount		Principal Balance		Unamortized Discount and Debt Issuance Costs		Net Carrying Amount
0.875% Convertible Senior Notes	$	178,264	$	5,019	$	173,245	$	0	$	0	$	0
1.25% Cash Convertible Senior Notes		345,000		7,552		337,448		345,000		22,112		322,888
Senior Secured Credit Facility		410,000		5,224		404,776		350,000		6,038		343,962
Other debt		0		0		0		748		0		748
Total debt	$	933,264	$	17,795	$	915,469	$	695,748	$	28,150	$	667,598
Less: Debt payable within one year		364,653		188		364,465		20,538		479		20,059
Total long-term debt, less current maturities	$	568,611	$	17,607	$	551,004	$	675,210	$	27,671	$	647,539

Interest Expense

Interest expense consisted of the following:

	Year Ended December 31,
(In thousands)	2019		2018		2017
Interest expense	$	26,648	$	35,366	$	23,001
Amortization of discounts and debt issuance costs		16,524		15,548		14,539
Total interest expense	$	43,172	$	50,914	$	37,540

Summary of Future Debt Payments

The following table summarizes future debt payments as of December 31, 2019:


(In thousands)	Total		2020		2021		2022		2023		2024		Thereafter
0.875% Convertible Senior Notes ⁽¹⁾	$	218,000	$	0	$	0	$	0	$	0	$	0	$	218,000
1.25% Cash Convertible Senior Notes ⁽²⁾		345,000		345,000		0		0		0		0		0
Term Loan		330,000		27,500		30,000		37,500		235,000		0		0
Revolving Facility ⁽²⁾		80,000		0		0		0		80,000		0		0
Other debt		0		0		0		0		0		0		0
Total debt	$	973,000	$	372,500	$	30,000	$	37,500	$	315,000	$	0	$	218,000

⁽¹⁾	^{Amount represents the face value of the 0.875% Convertible Senior Notes, which includes both the liability and equity portions.}

⁽²⁾	^{Assumes no cash conversion of the 1.25% Cash Convertible Senior Notes prior to their maturity on July 1, 2020.}

0.875% Convertible Senior Notes and the 1.25% Cash Convertible Senior Notes [Member]

Debt Instrument [Line Items]

Interest Expense Related to 0.875% Convertible Senior Notes and 1.25% Cash Convertible Senior Notes

Interest expense related to the 0.875% Convertible Senior Notes and 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)	2019		2018		2017
Coupon interest	$	4,429	$	4,312	$	4,312
Amortization of discounts and debt issuance costs		14,926		13,867		13,208
Total interest expense related to the convertible notes	$	19,355	$	18,179	$	17,520

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2019

Income Tax Disclosure [Abstract]

Geographic Breakdown of (Loss) Income Before Income Tax Benefits

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

	Year Ended December 31,
(In thousands)	2019			2018			2017
United States	$	(211,853	)	$	14,045		$	(190,053	)
Foreign		5,337			(907	)		16
(Loss) income from continuing operations before income taxes	$	(206,516	)	$	13,138		$	(190,037	)

Components of (Benefit) Provision for Income Taxes

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

	Year Ended December 31,
(In thousands)	2019			2018			2017
Current tax provision
Federal	$	6,607		$	838		$	407
State		2,778			737			1,796
Foreign		5,054			5,015			5,091
		14,439			6,590			7,294
Deferred tax provision
Federal		(28,732	)		(5,781	)		2,800
State		(8,763	)		236			(12,695	)
Foreign		(858	)		(576	)		(2,913	)
		(38,353	)		(6,121	)		(12,808	)
Income tax (benefit) provision	$	(23,914	)	$	469		$	(5,514	)

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

	Year Ended December 31,
(In thousands)	2019			2018			2017
United States federal tax at statutory rate	$	(43,368	)	$	2,759		$	(66,523	)
Items affecting federal income tax rate
Non-deductible acquisition and reorganization expenses		31			291			0
Non-deductible portion of Department of Justice Settlement		18,546			0			0
Research credits		(6,126	)		(6,185	)		(3,200	)
Change in unrecognized tax benefits		1,046			3			395
State income taxes, net of federal benefit		(3,787	)		715			(7,121	)
Compensation		4,664			3,213			2,950
Meals and entertainment		549			616			991
Impact of foreign operations		3,079			3,627			730
Provision-to-Return adjustments		(383	)		(2,140	)		(1,413	)
Deemed Dividends		473			373			1,289
Federal, state and local rate changes		(630	)		0			185
US Tax reform impact		(2,972	)		0			10,189
One time Mandatory Repatriation Toll Charge		0			0			5,155
Goodwill impairment		5,397			0			0
Non-deductible items		43			34			33
Noncontrolling interest		0			951			0
True-up of prior year income of Consolidated Investment		0			913			0
Valuation allowance		922			(5,208	)		47,959
Other		(1,398	)		507			2,867
Income tax (benefit) provision	$	(23,914	)	$	469		$	(5,514	)

Components of Deferred Tax Assets and Liabilities

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

	December 31,
(In thousands)	2019			2018
Deferred tax assets
Accruals and reserves, net	$	29,627		$	31,565
Allowance for doubtful accounts		11,507			11,378
Stock-based compensation, net		10,382			10,595
Deferred revenue		21,786			8,160
Operating and finance lease liabilities		22,085			0
Net operating loss carryforwards		37,717			36,649
Research and development tax credit		899			899
Other		7,488			10,784
Less: Valuation Allowance		(19,219	)		(18,734	)
Total deferred tax assets		122,272			91,296

Deferred tax liabilities
Prepaid expense		(5,372	)		(6,733	)
Property and equipment, net		(3,695	)		(7,442	)
Acquired intangibles, net		(111,284	)		(129,879	)
Operating and finance right-to-use assets		(17,255	)		0
Other		0			(676	)
Total deferred tax liabilities		(137,606	)		(144,730	)
Net deferred tax liabilities	$	(15,334	)	$	(53,434	)

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)	2019			2018
Non-current deferred tax assets, net	$	5,704		$	5,036
Non-current deferred tax liabilities, net		(21,038	)		(58,470	)
Non-current deferred tax liabilities, net	$	(15,334	)	$	(53,434	)

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)	2019			2018			2017
Beginning balance as of January 1	$	19,821		$	10,939		$	10,616
Increases for tax positions related to the current year		1,240			8,977			640
Decreases for tax positions related to prior years		0			0			(146	)
Increases for tax positions related to prior years		95			367			153
Decreases relating to settlements with taxing authorities		0			0			0
Increases acquired in business acquisitions		0			540			0
Foreign currency translation		3			(5	)		10
Reductions due to lapsed statute of limitations		(555	)		(997	)		(334	)
Ending balance as of December 31	$	20,604		$	19,821		$	10,939

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)	2019		2018		2017
Interest and penalties included in the provision for income taxes	$	229	$	543	$	446

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)	2019		2018
Interest and penalties included in the liability for uncertain tax positions	$	427	$	198

Stock Award Plan (Tables)

12 Months Ended

Dec. 31, 2019

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Stock-Based Compensation Expense

	Year Ended December 31,
(In thousands)	2019		2018		2017
Cost of revenue:
Software delivery, support and maintenance	$	2,075	$	2,184	$	2,879
Client services		4,067		3,997		4,484
Total cost of revenue		6,142		6,181		7,363
Selling, general and administrative expenses		27,348		24,213		23,497
Research and development		9,200		8,937		8,605
Total stock-based compensation expense	$	42,690	$	39,331	$	39,465

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, 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
Awarded		4,777			10.15
Vested		(2,360	)		12.62
Forfeited		(1,453	)		12.20
Unvested restricted stock units as of December 31, 2019		8,914		$	11.53

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, 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
Options granted		0			0
Options exercised		0			0
Options forfeited		(98	)		14.01
Balance as of December 31, 2019		1,234		$	13.67		1,234	$	13.67

Stock Option Activity

The following activity occurred under the Plan:

	Year Ended December 31,
(In thousands)	2019		2018		2017
Total intrinsic value of stock options exercised	$	0	$	69	$	45
Total fair value of share awards vested	$	29,793	$	28,954	$	25,220

Stock Option Awards

The following table summarizes information about stock options outstanding under the Plan as of December 31, 2019:

	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		1,225,743	$	13.66		1,225,743	$	13.66
$14.78 to $15.22		7,970	$	14.80		7,970	$	14.80
		1,233,713				1,233,713

Earnings (Loss) Per Share (Tables)

12 Months Ended

Dec. 31, 2019

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)	2019			2018			2017
Basic (loss) income per Common Share:
(Loss) income from continuing operations, net of tax	$	(182,602	)	$	12,669		$	(184,523	)
Net loss attributable to non-controlling interests		424			4,527			1,566
Net (loss) income from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(182,178	)	$	17,196		$	(182,957	)
Income from discontinued operations, net of tax		0			395,138			30,348
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations		0			(48,594	)		(43,850	)
Net income (loss) from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders		0			346,544			(13,502	)
Net (loss) income attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(182,178	)	$	363,740		$	(196,459	)

Weighted-average common shares outstanding		166,306			176,038			180,830

Basic (loss) income from continuing operations per Common Share	$	(1.10	)	$	0.10		$	(1.02	)
Basic income (loss) from discontinued operations per Common Share	$	0.00		$	1.97		$	(0.07	)
Net (loss) income attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(1.10	)	$	2.07		$	(1.09	)

Diluted (loss) income per Common Share:
(Loss) income from continuing operations, net of tax	$	(182,602	)	$	12,669		$	(184,523	)
Net loss attributable to non-controlling interests		424			4,527			1,566
Net (loss) income from continuing operations attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(182,178	)	$	17,196		$	(182,957	)
Income from discontinued operations, net of tax	$	0		$	395,138		$	30,348
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations		0			(48,594	)		(43,850	)
Net income (loss) from discontinued operations attributable to Allscripts Healthcare Solutions, Inc. stockholders		0			346,544			(13,502	)
Net (loss) income attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(182,178	)	$	363,740		$	(196,459	)

Weighted-average common shares outstanding		166,306			176,038			180,830
Dilutive effect of stock options, restricted stock unit awards and warrants		0			2,491			0
Weighted-average common shares outstanding assuming dilution		166,306			178,529			180,830

Diluted (loss) income from continuing operations per Common Share	$	(1.10	)	$	0.10		$	(1.02	)
Diluted income (loss) from discontinued operations per Common Share	$	0		$	1.94		$	(0.07	)
Net (loss) income attributable to Allscripts Healthcare Solutions, Inc. stockholders per Common Share	$	(1.10	)	$	2.04		$	(1.09	)

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)

2019

2018

2017

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

warrants excluded from calculation

27,945

26,175

26,515

Accumulated Other Comprehensive Loss (Tables)

12 Months Ended

Dec. 31, 2019

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, 2016 ⁽¹⁾		(6,028	)		(56,420	)		619			(61,829	)
Other comprehensive income (loss) 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 income (loss)		3,352			56,420			72			59,844
Balance as of December 31, 2017 ⁽²⁾		(2,676	)		0			691			(1,985	)
Other comprehensive (loss) income before reclassifications		(2,908	)		0			(264	)		(3,172	)
Net (gains) losses 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 ⁽³⁾		(5,584	)		0			195			(5,389	)
Other comprehensive income (loss) before reclassifications		1,192			0			61			1,253
Net (gains) losses reclassified from accumulated other comprehensive loss		0			0			(256	)		(256	)
Net other comprehensive income (loss)		1,192			0			(195	)		997
Balance as of December 31, 2019 ⁽³⁾	$	(4,392	)	$	0		$	0		$	(4,392	)

⁽¹⁾	^{Net of taxes of $463 thousand for unrealized net gains on marketable securities and foreign exchange contract derivatives.}

⁽²⁾	Net of taxes of $445 thousand for unrealized net gains on marketable securities and foreign exchange contract derivatives.

⁽³⁾	Tax effects for the years ended December 31, 2019 and 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, 2019
(In thousands)	Before-Tax Amount			Tax Effect			Net Amount
Foreign currency translation adjustments	$	1,192		$	0		$	1,192
Derivatives qualifying as cash flow hedges:
Foreign exchange contracts:
Net gains (losses) arising during the period		82			(21	)		61
Net (gains) losses reclassified into income		(344	)		88			(256	)
Net change in unrealized (losses) gains on foreign exchange contracts		(262	)		67			(195	)
Other comprehensive income	$	930		$	67		$	997

	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	)
Other comprehensive (loss) income	$	(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
Other comprehensive income	$	59,825		$	19		$	59,844

Derivative Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2019

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, 2019

Asset Derivatives

Liability Derivatives

(In thousands)

Balance Sheet Location

Fair Value

Balance Sheet Location

Fair Value

Derivatives qualifying as cash flow hedges:

Foreign exchange contracts

Prepaid expenses and

other current assets

Accrued expenses

Derivatives not subject to hedge accounting:

1.25% Call Option

Other assets

N/A

1.25% Embedded cash conversion option

N/A

Other liabilities

185

Total derivatives

185

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

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							Location of Gain (Loss) Reclassified from AOCI into Income	Amount of Gain (Loss) Reclassified from AOCI into Income
	Year Ended December 31,								Year Ended December 31,
(In thousands)	2019		2018			2017			2019		2018		2017
Foreign exchange contracts	$	82	$	(357	)	$	2,776	Cost of Revenue	$	124	$	165	$	905
								Selling, general and administrative expenses		83		138		692
								Research and development		137		214		1,065

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)	2019			2018			2017
1.25% Call Option	$	(9,020	)	$	(37,474	)	$	29,498
1.25% Embedded cash conversion option		9,789			37,803			(30,118	)
Net (loss) income included in other income, net	$	769		$	329		$	(620	)

Commitments (Tables)

12 Months Ended

Dec. 31, 2019

Commitments And Contingencies Disclosure [Abstract]

Summary of Expense Incurred under Atos Agreement

	Year Ended December 31,
(In thousands)	2019		2018		2017
Expenses incurred under Atos agreements	$	100,089	$	55,903	$	58,787

Discontinued Operations (Tables)

12 Months Ended

Dec. 31, 2019

Netsmart [Member]

Summary of Discontinued Operations in Financial Statements

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 and 2017:

	Year ended December 31,
(In thousands)	2018			2017
Major income and expense line items related to Netsmart:
Revenue:
Software delivery, support and maintenance	$	214,065		$	198,204
Client services		131,166			110,430
Total revenue		345,231			308,634
Cost of revenue:
Software delivery, support and maintenance		60,100			51,079
Client services		94,061			78,317
Amortization of software development and acquisition related assets		34,357			29,876
Total cost of revenue		188,518			159,272
Gross profit		156,713			149,362
Selling, general and administrative expenses		125,807			85,583
Research and development		25,315			17,937
Amortization of intangible and acquisition-related assets		24,029			16,409
Income from discontinued operations of Netsmart		(18,438	)		29,433
Interest expense		(59,541	)		(49,939	)
Other income		101			925
Loss from discontinued operations of Netsmart before income taxes		(77,878	)		(19,581	)
Income tax benefit		22,933			45,253
(Loss) income from discontinued operations, net of tax for Netsmart	$	(54,945	)	$	25,672

⁽¹⁾	Activity includes both Netsmart and intercompany transactions that would not have been eliminated if Netsmart’s results were not consolidated.

Horizon Clinicals and Series2000 [Member]

Summary of Discontinued Operations in Financial Statements

	Year ended December 31,
(In thousands)	2018			2017
Major classes of line items constituting pretax profit (loss) of discontinued operations for Horizon Clinicals and Series2000 Revenue Cycle:
Revenue:
Software delivery, support and maintenance	$	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.

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+ Details

Business Segments (Tables)

12 Months Ended

Dec. 31, 2019

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

	Year Ended December 31,
(In thousands)	2019			2018			2017
Revenue:
Provider	$	1,597,115		$	1,616,022		$	1,441,212
Veradigm		161,216			140,326			69,879
Unallocated Amounts		13,346			(6,386	)		(13,383	)
Total revenue	$	1,771,677		$	1,749,962		$	1,497,708

Gross profit:
Provider	$	672,206		$	710,063		$	674,112
Veradigm		104,896			100,708			43,817
Unallocated Amounts		(63,522	)		(86,228	)		(85,130	)
Total gross profit	$	713,580		$	724,543		$	632,799

Income (loss) from operations:
Provider	$	396,724		$	402,544		$	426,099
Veradigm		43,996			43,641			23,816
Unallocated Amounts		(465,176	)		(539,237	)		(437,431	)
Total income (loss) from operations	$	(24,456	)	$	(93,052	)	$	12,484

Supplemental Disclosures (Tables)

12 Months Ended

Dec. 31, 2019

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Supplemental Disclosures

	December 31
(In thousands)	2019		2018
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents	$	129,668	$	174,243
Restricted cash		7,871		10,552
Total cash, cash equivalents and restricted cash	$	137,539	$	184,795

	Year Ended December 31,
(In thousands)	2019		2018		2017
Cash paid during the period for:
Interest	$	19,604	$	28,888	$	21,183
Income taxes paid, net of tax refunds	$	42,972	$	10,108	$	6,675
Non-cash transactions:
Accretion of redemption preference on redeemable convertible non-controlling interest - discontinued operations	$	0	$	48,594	$	43,850
Exchange of NantHealth, Inc. common stock for net assets acquired of NantHealth provider/patient engagement solutions business including value assigned to commercial agreement	$	0	$	0	$	42,750
Obligations incurred to purchase capitalized software or enter into finance leases	$	0	$	1,501	$	1,897
Contributions of assets in exchange for equity interest	$	0	$	4,000	$	0
Issuance of treasury stock to commercial partner	$	701	$	1,121	$	334

Accrued Expenses

Accrued expenses consist of the following:

	December 31,
(In thousands)	2019		2018
Royalties, certain third-party product costs and licenses	$	35,431	$	26,371
Practice Fusion settlement		145,000		0
Other		90,231		80,697
Total Accrued expenses	$	270,662	$	107,068

Prepaids and other current assets.

Prepaids and other current assets consists of the following:

	December 31,
(In thousands)	2019		2018
Prepaid assets	$	146,036	$	140,352
Other current assets		1,954		2,103
Total Prepaid and other current assets	$	147,990	$	142,455

Other Assets

Other assets consist of the following:

	December 31,
(In thousands)	2019		2018
Fair value of 1.25% Call Option	$	84	$	9,104
Long-term deferred hosting fees		36,002		20,805
Long-term prepaid commissions		32,860		32,660
Investments in non-marketable securities		43,806		37,040
Long-term deposits and other assets		12,015		9,597
Total Other assets	$	124,767	$	109,206

Geographic Information (Tables)

12 Months Ended

Dec. 31, 2019

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)	2019		2018		2017
United States	$	1,701,173	$	1,697,178	$	1,440,842
Canada		16,495		15,377		15,818
Other international		54,009		37,407		41,048
Total	$	1,771,677	$	1,749,962	$	1,497,708

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,
(In thousands)	2019		2018
United States	$	78,122	$	111,836
India		5,321		4,231
Israel		3,240		3,830
Canada		51		60
Other international		1,605		1,956
Total	$	88,339	$	121,913

Quarterly Financial Information (Unaudited) (Tables)

12 Months Ended

Dec. 31, 2019

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)	2019			2019 ⁽²⁾			2019 ⁽¹⁾			2019
Revenue	$	450,984		$	444,184		$	444,460		$	432,049
Cost of revenue		270,923			268,882			260,338			257,954
Gross profit		180,061			175,302			184,122			174,095
Selling, general and administrative expenses		112,835			101,152			105,542			100,245
Research and development		62,912			63,873			63,414			64,310
Asset impairment charges		6,800			248			3,691			98
Goodwill impairment charge		25,700			0			0			0
Amortization of intangible and acquisition-related assets		6,840			6,847			6,732			6,797
(Loss) income from operations		(35,026	)		3,182			4,743			2,645
Interest expense		(11,725	)		(10,839	)		(10,424	)		(10,184	)
Other income (loss), net		4,798			781			(144,994	)		513
(Impairment) recovery on long-term investments		(1,696	)		0			0			1,045
Equity in net income (loss) of unconsolidated investments		125			386			218			(64	)
Loss from continuing operations before income taxes		(43,524	)		(6,490	)		(150,457	)		(6,045	)
Income tax benefit (provision)		24,554			765			527			(1,932	)
Net loss		(18,970	)		(5,725	)		(149,930	)		(7,977	)
Net loss attributable to non-controlling interest		0			0			0			424
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders	$	(18,970	)	$	(5,725	)	$	(149,930	)	$	(7,553	)

Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per share: ⁽⁵⁾
Basic
Continuing operations	$	(0.12	)	$	(0.03	)	$	(0.90	)	$	(0.04	)
Discontinued operations	$	0.00		$	0.00		$	0.00		$	0.00
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$	(0.12	)	$	(0.03	)	$	(0.90	)	$	(0.04	)

Diluted
Continuing operations	$	(0.12	)	$	(0.03	)	$	(0.90	)	$	(0.04	)
Discontinued operations	$	0.00		$	0.00		$	0.00		$	0.00
Net loss attributable to Allscripts Healthcare Solutions, Inc. stockholders per share	$	(0.12	)	$	(0.03	)	$	(0.90	)	$	(0.04	)

	Quarter Ended
	December 31,			September 30,			June 30,			March 31,
(In thousands, except per share amounts)	2018			2018			2018 ⁽⁴⁾			2018 ⁽³⁾
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 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	)
Net loss attributable to non-controlling interest		1,033			4			2,700			790
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: ⁽⁵⁾
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	)

⁽¹⁾	Results of operations for the quarter include the results of operations of a third party engaged in a specialty prescription drug platform since June 10, 2019.

⁽²⁾	Results of operations for the quarter include the results of operations of Pinnacle and Diabetes and Collaborative Registries since July 2, 2019.

⁽³⁾	Results of operations for the quarter include the results of operations of Practice Fusion since February 13, 2018.

⁽⁴⁾	Results of operations for the quarter include the results of operations of Health Grid since May 18, 2018.

⁽⁵⁾	The sum of the quarterly per share amounts may not equal per share amounts reported for year to date periods. This is due to changes in the number of weighted-average shares outstanding and the effects of rounding for each period.

Basis of Presentation and Significant Accounting Policies - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2019	Jun. 18, 2013
Basis Of Presentation And Significant Accounting Policies [Line Items]
Percentage of revenues	No single client accounted for more than 10% of our revenue in the years ended December 31, 2018 and 2017.
Customer concentration	No client represented more than 10% of accounts receivable as of December 31, 2019 and 2018.
Minimum additional reserves for estimated credit losses	$ 20,000,000
Minimum [Member] \| Capitalized Software [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Capitalized software estimated economic life	3 years
Maximum [Member] \| Capitalized Software [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%	1.25%

Basis of Presentation and Significant Accounting Policies - Unamortized Balances of Capitalized Software (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Accounting Policies [Abstract]
Software development costs	$ 428,641	$ 317,637
Less: accumulated amortization	(184,712)	(107,977)
Software development costs, net	$ 243,929	$ 209,660

Basis of Presentation and Significant Accounting Policies - Capitalized Software Development Costs, Write Offs and Amortization of Capitalized Software Development Costs (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Accounting Policies [Abstract]
Capitalized software development costs	$ 113,836	$ 113,308	$ 94,740
Write-offs and divestitures of capitalized software development costs	0	34,083	0
Amortization of capitalized software development costs	$ 79,567	$ 64,409	$ 51,589

Basis of Presentation and Significant Accounting Policies - Company Contributions to Employee Benefit Plan (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Accounting Policies [Abstract]
Company contributions to employee benefit plans	$ 24,782	$ 29,393	$ 18,861

Revenue from Contracts with Customers - Additional Information (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2019 USD ($) Revenue_Stream	Dec. 31, 2018 USD ($)
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Number of primary revenue streams \| Revenue_Stream	2
Total backlog	$ 4,400.0
Total backlog, percentage, year one	35.00%
Total backlog, percentage after year one	65.00%
Selling, General and Administrative Expenses [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost Amortization	$ 33.8	$ 29.7
Prepaid Expenses and Other Current Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross	20.8	24.7
Other Assets [Member]
Revenue Initial Application Period Cumulative Effect Transition [Line Items]
Capitalized Contract Cost, Gross	$ 32.9	$ 33.8
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 - Summary of Revenue Recognized on Various Performance Obligations and Elected Accounting Expedients (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Revenue From Contract With Customer [Abstract]
Revenue related to deferred revenue balance at beginning of period	$ 171,799	$ 151,543	$ 146,150	$ 126,184	$ 141,127	$ 153,151	$ 196,163	$ 181,398
Revenue related to new performance obligations satisfied during the period	216,072	228,927	233,696	248,221	237,963	225,641	180,001	200,232
Revenue recognized under "right-to-invoice" expedient	60,826	61,814	62,245	55,923	60,593	51,288	62,533	49,403
Reimbursed travel expenses, shipping and other revenue	2,287	1,900	2,369	1,721	2,663	2,350	2,767	2,689
Total revenue	$ 450,984	$ 444,184	$ 444,460	$ 432,049	$ 442,346	$ 432,430	$ 441,464	$ 433,722	$ 1,771,677	$ 1,749,962	$ 1,497,708

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, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Disaggregation Of Revenue [Line Items]
Recurring revenue									$ 1,395,869	$ 1,411,742	$ 1,176,720
Non-recurring revenue									375,808	338,220	320,988
Total revenue	$ 450,984	$ 444,184	$ 444,460	$ 432,049	$ 442,346	$ 432,430	$ 441,464	$ 433,722	1,771,677	1,749,962	1,497,708
Operating Segments [Member] \| Provider [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									1,597,115	1,616,022	1,441,212
Operating Segments [Member] \| Veradigm [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									161,216	140,326	69,879
Unallocated [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									13,346	(6,386)	(13,383)
Software delivery, Support and Maintenance [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									1,126,486	1,128,263	958,187
Software delivery, Support and Maintenance [Member] \| Operating Segments [Member] \| Provider [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									965,925	995,193	904,391
Software delivery, Support and Maintenance [Member] \| Operating Segments [Member] \| Veradigm [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									148,352	130,945	64,360
Software delivery, Support and Maintenance [Member] \| Unallocated [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									12,209	2,125	(10,564)
Client services [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									645,191	621,699	539,521
Client services [Member] \| Operating Segments [Member] \| Provider [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									631,190	620,829	536,821
Client services [Member] \| Operating Segments [Member] \| Veradigm [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									12,864	9,381	5,519
Client services [Member] \| Unallocated [Member]
Disaggregation Of Revenue [Line Items]
Total revenue									$ 1,137	$ (8,511)	$ (2,819)

Leases - Additional Information (Detail)	12 Months Ended
Leases - Additional Information (Detail)	Dec. 31, 2019
Minimum [Member]
Lessee Lease Description [Line Items]
Operating leases, remaining lease terms	1 year
Finance leases, remaining lease terms	1 year
Maximum [Member]
Lessee Lease Description [Line Items]
Operating leases, remaining lease terms	9 years
Finance leases, remaining lease terms	9 years
Operating leases, options to extend leases term	5 years
Finance leases, options to extend leases term	5 years
Operating leases, options to terminate leases term	1 year
Finance leases, options to terminate leases term	1 year

Leases - Summary of Total Costs Associated with Leased Assets (Detail)
$ in Thousands

12 Months Ended

Dec. 31, 2019

USD ($)

Leases [Abstract]

Operating lease cost

$ 27,962

^[1]

Less: Sublease income

(3,265)

Total operating lease costs

24,697

Finance lease costs:

Amortization of right-of-use assets

157

^[2]

Interest on lease liability

^[3]

Total finance lease costs

$ 166

[1]	Operating lease costs are recognized on a straight-line basis and are included in Selling, general and administrative expenses within the consolidated statement of operations.
[2]	Amortization of finance right-of-use assets is recognized on a straight-line basis and is included in in Selling, general and administrative expenses within the consolidated statement of operations.
[3]	Interest on finance lease liabilities is recorded as Interest expense within the consolidated statement of operations.

Leases - Supplemental Information for Operating and Finance Leases (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2019 USD ($)
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 30,039
Operating cash flows from finance leases	9
Financing cash flows from finance leases	158
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	143,602
Finance leases	$ 263

Leases - Summary of Balance Sheet Location and Balances for Operating and Finance Leases (Detail) - USD ($)
$ in Thousands

Dec. 31, 2019

Dec. 31, 2018

Operating leases:

Right-of-use assets - operating leases

$ 98,020

$ 0

Current operating lease liabilities

23,137

Long-term operating lease liabilities

95,162

Finance leases:

Fixed assets, gross

408,690

401,116

Less: Accumulated depreciation

(320,351)

(279,203)

Fixed assets, net

88,339

$ 121,913

Current finance lease liabilities

^[1]

$ 82

Finance Lease, Liability, Current, Statement of Financial Position [Extensible List]

us-gaap:AccruedLiabilitiesCurrent

Long-term finance lease liabilities

^[2]

$ 45

Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List]

us-gaap:OtherLiabilitiesNoncurrent

Weighted average remaining lease term (in years)

Operating leases

6 years

Finance leases

2 years

Weighted average discount rate

Operating leases

4.40%

Finance leases

5.10%

Finance Leases [Member]

Finance leases:

Fixed assets, gross

$ 524

Less: Accumulated depreciation

(392)

Fixed assets, net

$ 132

[1]	Current finance lease liabilities are included in Accrued expenses within the consolidated balance sheets.
[2]	Long-term finance lease liabilities are included in Other liabilities within the consolidated balance sheets.

Leases - Summary of Future Maturities of Lease and Non-Lease Components (Detail) - USD ($)
$ in Thousands

Dec. 31, 2019

Dec. 31, 2018

Operating Leases [Abstract]

Operating Leases, 2020

$ 27,647

Operating Leases, 2021

23,277

Operating Leases, 2022

21,640

Operating Leases, 2023

19,497

Operating Leases, 2024

13,862

Operating Leases, Thereafter

28,580

Operating Leases, Total lease liabilities

134,503

Operating Leases, Less: Amount representing interest

(16,204)

Operating Leases, Less: Short-term lease liabilities

(23,137)

$ 0

Operating Leases, Total long-term lease liabilities

95,162

$ 0

Finance Leases [Abstract]

Finance Leases, Thereafter

Finance Leases, Total lease liabilities

132

Finance Leases, Less: Amount representing interest

(5)

Finance Leases, Less: Short-term lease liabilities

^[1]

(82)

Finance Leases, Total long-term lease liabilities

^[2]

$ 45

[1]	Current finance lease liabilities are included in Accrued expenses within the consolidated balance sheets.
[2]	Long-term finance lease liabilities are included in Other liabilities within the consolidated balance sheets.

Business Combinations and Other Investments - Additional Information (Detail) - USD ($)	Jul. 02, 2019	Mar. 01, 2019	Jun. 15, 2018
Business Acquisition [Line Items]
Acquisition of outstanding minority interest			$ 6,900,000
ACC Pinnacle and Diabetes Collaborative Registries [Member]
Business Acquisition [Line Items]
Total purchase price	$ 19,700,000
Purchase price initial payment	11,700,000
Potential milestone/earnout payments	5,000,000.0
ACC Pinnacle and Diabetes Collaborative Registries [Member] \| Maximum [Member]
Business Acquisition [Line Items]
Potential milestone/earnout payments	$ 8,000,000.0
Pulse8, Inc. [Member]
Business Acquisition [Line Items]
Acquisition of outstanding minority interest		$ 53,800,000
Pulse8, Inc. [Member] \| Maximum [Member]
Business Acquisition [Line Items]
Potential milestone/earnout payments		$ 5,000,000.0

Business Combinations and Other Investments - Acquisition of Health Grid - Additional Information (Detail) - Health Grid [Member] - USD ($)		12 Months Ended
	May 18, 2018	Dec. 31, 2018
Business Acquisition [Line Items]
Date of acquisition	May 18, 2018
Purchase price in cash	$ 110,000,000.0
Purchase price transferred, initial payment	60,000,000
Potential earnout payments	23,915,000
Pre-paid potential earnout payments	10,000,000
Goodwill expected to be tax deductible		$ 0
Selling, General and Administrative Expenses [Member]
Business Acquisition [Line Items]
Acquisition-related costs		$ 500,000
Level 3 [Member]
Business Acquisition [Line Items]
Potential earnout payments	23,900,000
Maximum [Member]
Business Acquisition [Line Items]
Potential earnout payments	50,000,000.0
Remaining potential payments	$ 40,000,000.0

Business Combinations and Other Investments - Schedule of Consideration Transaction (Detail) - USD ($) $ in Thousands	May 18, 2018	Feb. 13, 2018
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
Add: Closing cash		14,951
Less: Adjustment to assumed indebtedness		(1,684)
Total consideration paid		$ 113,640

Business Combinations and Other Investments - Assets Acquired and Liabilities Assumed (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018	May 18, 2018	Feb. 13, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Goodwill	$ 1,362,017	$ 1,373,744			$ 1,292,747
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

Business Combinations and Other Investments - Acquired Intangible Assets Amortization (Detail) - USD ($) $ in Thousands	May 18, 2018	Feb. 13, 2018
Health Grid [Member]
Business Acquisition [Line Items]
Intangible assets	$ 41,000
Health Grid [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Intangible assets, Useful Life	15 years
Intangible assets, Fair Value	$ 28,000
Health Grid [Member] \| Technology [Member]
Business Acquisition [Line Items]
Intangible assets, Useful Life	8 years
Intangible assets, Fair Value	$ 13,000
Practice Fusion, Inc. [Member]
Business Acquisition [Line Items]
Intangible assets		$ 67,100
Practice Fusion, Inc. [Member] \| Customer Relationships - Physician Practices [Member]
Business Acquisition [Line Items]
Intangible assets, Useful Life		15 years
Intangible assets, Fair Value		$ 29,000
Practice Fusion, Inc. [Member] \| Customer Relationships - Pharmaceutical Partners [Member]
Business Acquisition [Line Items]
Intangible assets, Useful Life		20 years
Intangible assets, Fair Value		$ 19,400
Practice Fusion, Inc. [Member] \| Technology [Member]
Business Acquisition [Line Items]
Intangible assets, Useful Life		8 years
Intangible assets, Fair Value		$ 14,800
Practice Fusion, Inc. [Member] \| Tradenames [Member]
Business Acquisition [Line Items]
Intangible assets, Useful Life		10 years
Intangible assets, Fair Value		$ 3,900

Business Combinations and Other Investments - Acquisition of Practice Fusion, Inc - Additional Information (Detail) - Practice Fusion, Inc. [Member] - USD ($)		12 Months Ended
	Feb. 13, 2018	Dec. 31, 2018
Business Acquisition [Line Items]
Date of acquisition	Feb. 13, 2018
Total consideration paid	$ 113,640,000
Goodwill expected to be tax deductible		$ 0
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, 2019	Dec. 31, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Pre-tax gain (loss) on sale of business	$ 0	$ 0	$ 173,129	$ (871)	$ 0	$ 172,258	$ 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, Divestitures and Investments - Additional Information (Detail) - USD ($)
$ in Thousands

3 Months Ended

12 Months Ended

Jun. 15, 2018

Apr. 02, 2018

Mar. 15, 2018

Feb. 06, 2018

Dec. 31, 2018

Sep. 30, 2018

Jun. 30, 2018

Mar. 31, 2018

Dec. 31, 2019

Dec. 31, 2018

Dec. 31, 2017

Acquisition of outstanding minority interest in third party

$ 6,900

Pre-tax gain (loss) on sale of business

$ 0

$ 173,129

$ (871)

$ 0

$ 172,258

$ 0

Equity method investments

^[1]

10,667

11,332

10,667

Cash paid for business acquisitions

23,443

177,233

169,823

Goodwill

1,373,744

1,362,017

1,373,744

1,292,747

Total consideration for non marketable equity securities and convertible note

$ 7,191

16,934

$ 5,606

Cost Method Equity Investments [Member] | 2018 Convertible Note [Member]

Total consideration for non marketable equity securities and convertible note

1,800

Strategic Sourcing Business [Member]

Effective date of divestiture

March 15, 2018

Payment to acquire additional interest in a new entity

$ 2,700

Minority interest percentage

35.70%

Equity method investments

$ 4,000

4,000

Initial pre-tax loss on sale of business

900

Additional pre-tax loss on sale of business

4,700

Cloud-based Analytics Software Platform Provider [Member]

Cash paid for business acquisitions

Date of acquisition

Feb. 06, 2018

$ 8,000

Goodwill

6,600

Liabilities assumed, account receivable

800

Liabilities assumed, deferred revenue

600

Liabilities assumed, deferred tax liabilities net

500

Goodwill expected to be tax deductible

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

Intangible assets, useful life

Intangible assets

1,100

8 years

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

Intangible assets, useful life

Intangible assets

$ 600

1 year

2018 Business Acquisitions [Member] | Cost Method Equity Investments [Member]

Total consideration for non marketable equity securities and convertible note

11,700

One Content Business [Member]

Pre-tax gain (loss) on sale of business

Date of divestiture

Apr. 02, 2018

Total consideration paid

$ 260,000

$ 177,900

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

Business Combinations and Other Investments - Summary of Other Equity Investments Included in Other Assets (Detail)
$ in Thousands

12 Months Ended

Dec. 31, 2019

USD ($)

Investment

Dec. 31, 2018

USD ($)

Investments In Affiliates Subsidiaries Associates And Joint Ventures [Abstract]

Equity method investments, Number of Investees | Investment

^[1]

Cost less impairments, Number of investees | Investment

Total long-term equity investments, Number of Investees | Investment

Equity method investments, Original Cost

^[1]

$ 7,407

Cost less impairment, Original Cost

43,874

Total long-term equity investments, Original Cost

51,281

Equity method investments, Carrying Value

^[1]

11,332

$ 10,667

Cost less impairment, Carrying Value

32,462

25,923

Total long-term equity investments, Carrying Value

$ 43,794

$ 36,590

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

Business Combinations and Other Investments - Impairment of and Losses on Long-term Investments - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Impairment of long-term investments	$ 651	$ 15,487	$ 165,290
Fair value of marketable securities and impairment charges			(142,200)
Available for sale marketable securities cost basis			205,600
Loss on final disposition of securities			20,700
Long-term Equity Investments [Member]
Business Acquisition [Line Items]
Impairment of long-term investments	1,700
Impairment recoveries	$ 1,000
Cost Method Equity Investments [Member]
Business Acquisition [Line Items]
Impairment of long-term investments			$ 2,100

Fair Value Measurements - Additional Information (Detail)	Dec. 31, 2019	Dec. 31, 2018	Jun. 18, 2013
1.25% Cash Convertible Senior Notes [Member]
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items]
Interest rate	1.25%		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%

Fair Value Measurements - Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Prepaid expenses and other current assets	$ 147,990	$ 142,455
Total assets	84	9,366
Total liabilities	19,716	35,819
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	262
Contingent Consideration Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	17,116	10,528
Contingent Consideration Long Term [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	2,415	15,317
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	185	9,974
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 Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	0	0
Level 1 [Member] \| Contingent Consideration Long Term [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
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	0	262
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	0	262
Level 2 [Member] \| Contingent Consideration Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	0	0
Level 2 [Member] \| Contingent Consideration Long Term [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
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	84	9,104
Total liabilities	19,716	35,819
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 Current [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accrued expenses	17,116	10,528
Level 3 [Member] \| Contingent Consideration Long Term [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other liabilities	2,415	15,317
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	185	9,974
1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Other assets	84	9,104
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	$ 84	$ 9,104

Fair Value Measurements - Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Parenthetical) (Detail)	Dec. 31, 2019	Dec. 31, 2018
1.25% Notes Embedded Cash Conversion Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Interest rate	1.25%
1.25% Call Option [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Interest rate	1.25%	1.25%

Fair Value Measurements - Summary of Changes in Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2019

Dec. 31, 2018

Contingent Consideration [Member]

Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]

$ 25,845

$ 7,036

Additions

12,144

24,551

Payments/write-downs

(18,900)

^[1]

(6,067)

Fair value adjustments

442

325

1.25% Notes Call Spread Overlay [Member]

19,531

25,845

Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Roll Forward]

(870)

(1,199)

Additions

Payments/write-downs

Fair value adjustments

769

329