Significant Accounting Policies - Accounts Receivable (Details) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2016
Dec. 31, 2015
Dec. 31, 2014
Organization, Consolidation and Presentation of Financial Statements [Abstract]      
Third-Party Medicaid settlements receivable $ 454    
Third-Party Medicaid settlements liability 179 $ 5,222  
Allowance for Doubtful Accounts Receivable [Roll Forward]      
Allowance for doubtful accounts, beginning balance 18,322 5,329 $ 5,028
Provision for doubtful accounts 24,212 23,578 9,509
Accounts written off, net of recoveries (12,662) (10,585) (9,208)
Allowance for doubtful accounts, ending balance 29,872 18,322 $ 5,329
Optical products receivable $ 7,042 $ 8,434