Quarterly report pursuant to Section 13 or 15(d)

Contingencies (Details)

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Contingencies (Details) - USD ($)
$ in Millions
9 Months Ended
Mar. 09, 2015
Sep. 30, 2016
Commitments and Contingencies Disclosure [Abstract]    
Kentucky Spirit performance bond   $ 25
Loss Contingencies [Line Items]    
Commonwealth of Kentucky alleged increased program costs $ 40  
Secretary of the Kentucky Cabinet for Health and Family Services determination letter damages prejudgment interest rate (percent) 8.00%  
Commonwealth of Kentucky, expenditures due to departure | Minimum    
Loss Contingencies [Line Items]    
Commonwealth of Kentucky alleged increased program costs   28
Commonwealth of Kentucky, expenditures due to departure | Maximum    
Loss Contingencies [Line Items]    
Commonwealth of Kentucky alleged increased program costs   40
Commonwealth of Kentucky, CMS expenditures | Minimum    
Loss Contingencies [Line Items]    
Commonwealth of Kentucky alleged increased program costs   92
Commonwealth of Kentucky, CMS expenditures | Maximum    
Loss Contingencies [Line Items]    
Commonwealth of Kentucky alleged increased program costs   $ 134