Earnings Labs

HeartBeam, Inc. (BEAT)

Q4 2017 Earnings Call· Fri, Feb 23, 2018

$0.88

-0.07%

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Transcript

Operator

Operator

Good afternoon. Thank you for joining us for the BioTelemetry Fourth Quarter 2017 Earnings Conference Call. Certain statements during the conference call and question-and-answer period to follow may relate to future events and expectations and as such constitute forward-looking statements within the meaning of the Private Securities and Litigation Act of 1995. Such statements involve known and unknown risks, uncertainties, and other factors which may cause the actual results, performance or achievements of the Company in the future to be materially different from those statements that the Company’s executives may make today. These risks are described in detail in our public filings with the Securities and Exchange Commission, including our latest periodic report on Form 10-K or 10-Q. We assume no duty to update these statements. At this time, all participants have been placed on a listen-only mode. The floor will be opened for questions and comments following the presentation. It is now my pleasure to turn the floor over to your host, Mr. Joseph Capper. Sir, you may begin.

Joseph Capper

Management

Thank you, operator, and good afternoon, everyone. I’m Joe Capper, President and CEO of BioTelemetry. I’m joined by Heather Getz, our Chief Financial Officer. I’ll start with a recap of our fourth quarter performance and other key developments. Heather will take you through a more detailed review of our financial results. I will then provide commentary on how we see the business continuing to evolve throughout 2018. After our prepared remarks, we will open up the call for questions. As you will hear, we had a truly exceptional quarter. I could not be more pleased with how the team is working together to deliver on our objectives. On this call, we will update you on the faster than anticipated integration of LifeWatch and the realization of the associated synergies which are running well ahead of schedule. You will also learn that our research services division has regained its momentum and that backlog stands at a record level. We will elaborate on our role as a contributor to the high profile Apple Heart study. We will also detail how our population health business is progressing. Last, you will learn that we didn’t miss a beat while integrating LifeWatch and posting another record setting quarter in which we set all time highs in revenue, EBITDA, and EBITDA margin making it our 22nd consecutive growth quarter. As you can tell, there is no shortage of good news to report this quarter. So let's dig into the detail behind these many positive accomplishments. For the full year we far exceeded what were fairly aggressive growth objectives, driven in large part by the highly strategic acquisition of LifeWatch AG back in July. Since that time, the integration has been tracking well ahead of schedule. In many cases we have achieved key milestones months in advance.…

Heather Getz

Management

Thank you, Joe, and good afternoon everyone. As Joe just announced, the fourth quarter of 2017 marked our 22nd consecutive quarter of year-over-year revenue growth with total revenue of $91.7 million. This represents a 70% increase as compared to the fourth quarter of 2016. Healthcare revenue was very strong with an increase of $36.3 million, resulting from volume increases, driven by the acquisition of LifeWatch, a 12% increase in pro forma MCT volumes and a favorable payer mix. Partially offsetting these positive drivers was the lower Medicare rate that became effective January 1, which again as expected impacted by about $1 million in the quarter. On a pro forma basis, our healthcare revenue grew by 10% and if we did not have the Medicare rate reduction, the revenue growth would have been 12%. Our research revenue increased 20% or $1.7 million largely due to a higher volume of imaging studies resulting from new customers. This increase was partially offset by pressure on our cardiac safety side of the business. Moving to gross profit. Our margin for the fourth quarter was 59% versus 61% in the fourth quarter of 2016. The decline in margin was primarily due to the impact of the LifeWatch and Telcare acquisition which carry a lower margin than our existing business and the Medicare rate reduction. This decline was partially offset by volume and operational efficiencies. Our third quarter adjusted EBITDA of $22.9 million was our highest quarterly adjusted EBITDA in the company's history and represented a 25% return on revenue. Similar to the dollar amount, this return is the highest EBITDA return in the company's history and was above our expectations. It reflects the positive impact of targeted investments and faster than anticipated synergies realized from the integration of LifeWatch. Remember, pre-acquisition on a pro forma…

Joseph Capper

Operator

Thanks, Heather. As you have just heard, we had an excellent fourth quarter. Building on the momentum we have cultivated over the last five years. Our strategy is yielding the results we expected and we continue to broaden our opportunities. We are in the early stages of several potentially significant drivers of future growth. The importance of the acquisition of LifeWatch should not be under-estimated. This transaction has advanced our growth plans by several years. To ensure our continued success throughout 2018, we will focus on completing the integration of LifeWatch, expanding our comprehensive approach with the full market release of a series of patch products, both MCT and extended wear Holter. Continuing to grow our research services backlog at the accelerated rate we are now experiencing and converting that backlog into revenue. Building out our digital population heath management business and expanding on key partnerships we have developed. Given our excellent results, the momentum of our business, the stable reimbursement environment and greater visibility into the synergies created by the acquisition, the company has never been in a stronger position. All in all, things are tracking better than anticipated. Heather spoke about how we see 2018 beginning to take shape. We are clearly in store for another great year. While we are pleased with the progress of the company, we get far more excited about what lies ahead. We currently operate the powerful cardiac monitoring and clinical research businesses which have the potential to produce solid growth for years to come. This provides an excellent platform from which to commercialize additional innovative connected health solutions. As such, we plan to be more assertive to our 2018 in developing these opportunities. As I close, I would again like to thank those of you who help deliver our 22nd consecutive growth quarter. Let's continue to build on the excellent momentum we have built together. With that, we will now pause and open the call to your questions. Operator, we are ready for our first question.

Operator

Operator

[Operator Instructions] Our first question comes from Brooks O'Neil with Lake Street Capital Markets. Your line is now open.

Brooks O'Neil

Analyst

Congratulations on a terrific year, you guys. I was wondering if you would elaborate in any way on sort of what we should expect in terms of the pacing of your launch of the new MCOT products and the extended wear Holters.

Joseph Capper

Operator

As far as MCOT, Brooks, we put a few thousand on the fourth quarter. Feedback was tremendous. So we are in the process of accelerating the production of that product probably by kind of the end of -- I would say more like the middle of March we will see full production up and running. We are rolling product off the line now. So kind of the end of the first quarter well into the second quarter we will be at full capacity. And that’s not a product, it's a swap out. It's kind of an inline update to the existing MCP product line.

Brooks O'Neil

Analyst

Okay. And how about extended wear Holters, Joe.

Joseph Capper

Operator

Pretty much the same schedule, Brooks. We did not build enough to meet demand last year, so we accelerated the production of that as well. Heather talked about some of the uses of a cash in the quarter that had something to do with it. So we are accelerating that production as well. And pretty much on the same schedule I just outlined for MCT.

Brooks O'Neil

Analyst

Great. And would you estimate that you will realize all of the available synergies related to LifeWatch in 2018 or do you think there could be a tail that might go into 2019 as well, I think by the end of 2018, we will be on the run rate to have achieved the $30 million. What we are somewhat conservative about, Brooks, is any dis-synergies, right. What are additional expenses, do we incur to operate the business that we didn’t anticipate pre-merger. So we like the $30 million number. That’s when we sort of pegged in our public statements. We are tracking well ahead of schedule. Initially we thought that we wouldn’t get as much upfront as we have been able to realize. As you know when you do integrations like this, squeezing the last few drops tend to be the more difficult ones to get out, so to speak. Integration of systems and products and things like that take a little bit longer.

Brooks O'Neil

Analyst

Sure. That’s great. I appreciate all that color. So I just want to ask one more. You commented about some of the future partnerships and opportunities in population health. We obviously have some sense of what's going on with the Apple project. Can you just talk a little bit about the diabetes work you are doing and would be willing to say if some of the work you are doing with partnerships, goes beyond what's been announced so far, or are we really still thinking about what you have talked about publically.

Joseph Capper

Operator

So we definitely have a few more interesting conversations that are ongoing, Brooks and obviously I can't elaborate. I would have liked to spend a little bit more time on that business. In 2017 that was my intent as we entered the year. Obviously, we were able to acquire LifeWatch and close that transaction. So as you would expect, executive management team's focus sort of shifted. So I would anticipate putting more emphasis on that business in 2018. We really like it. We think that there is big potential. So more to come. And, yes, there are other conversations that were ongoing.

Brooks O'Neil

Analyst

It's great. Just would sneak in one last one. Are we thinking that you could get beyond Arrhythmia management and diabetes in 2018 or is that going to be your primary focus.

Joseph Capper

Operator

If I could just continue to build out the current business in PHM, maybe add a few more capabilities to it. I am not as concerned about moving into other disease states at this juncture. I think the main thought process here is let's build a platform. It's flexible enough that we could add other capabilities. I don’t want to just go out and collect capabilities until I am ready to handle them all.

Operator

Operator

Thank you. And our next question comes from Bruce Nudell from SunTrust. Your line is now open.

Bruce Nudell

Analyst

Joe, the extended Holter market seems to have enjoyed a renaissance with the emergence of [GO] [ph]. How do you view the durability of that segment's growth and how competitive do you believe the ePatch to be. The competitive dimensions that I am interested in are length of monitoring 7 versus 14 days, sensitivity, specificity, predictive accuracy, as well as ergonomics.

Joseph Capper

Operator

Yes. So let me answer it in reverse. We actually have two products in the category. We have CardioKey which is a very light weight lean wire, configuration with micro patches that attach to the body. And that is easily a 14 day product. Very easy for the patient to move around. And then we have the ePatch, which as you mentioned has a shorter duration today but there is projects in development to extend that and that’s strictly a patch today. But again, there is a project to move that into a more flexible configuration as well. So it could also be a lead wire configuration. So one of the feedback is, patches are for everybody and this came back very loud and clear to us from our market research. So I do think we have a comparable product line. In fact I think it's more flexible than one that’s out there today. That’s the initial feedback that we are getting. We also know that when you sell a product, it helps if you have more than one choice. One size fits all is not the answer for most healthcare markets that I have participated in. So our portfolio approach, the reason we still market traditional 24-40 hour Holters and MCT and now extended wear Holters is because we are trying to offer the broadest product portfolio possible. Helps quite a bit in relationship building with large accounts. In terms of viability of the market, I don’t know. That product was on the market for several years before as you said, it had a resurgence or renaissance. It was on the market with no competition and interestingly enough, it still operates under a temporary code which I am sure as you are aware means that there is a tremendous amount of inherent risk around reimbursement. So that’s the thing that kind of gives me a little bit [indiscernible] when I think about growing that product category. I can assure you that if it does have viability, if it moves into permanent CPT code, we will take our unfair share of that market.

Bruce Nudell

Analyst

And just to follow up on that question. In terms of magic sauce via discrimination, accuracy -- you know sensitivity, specificity, predictive accuracy for your product line and the extended Holter demand.

Joseph Capper

Operator

We think that we are as good, if not better, than everybody else. That’s one of the reasons why you have multiple wear options likely. Wires, lead wires produce a better signal. Some clinicians are definitely more concerned with product signal quality which leads to specificity and sensitivity and ultimately diagnostic yield. So we think we can pair favorably to what's out there.

Bruce Nudell

Analyst

And my second question in regards to segmentation in the MCOT market. Patient's segment of course is different than in the extended Holter market, probably with more syncope patients rather than AF patients. But AF is still, probably in the majority. What are the patient segmentation factors in the AF segment that drives a doc to chose and extended Holter, like your products or [GO] [ph] versus an MCOT. Also I believe that [GO 80] [ph] is a two-week product versus a four week product and MCOT. And how would that influence once a doctor's' choice if they think telemetry is required.

Joseph Capper

Operator

I would tell you that the average -- again, I am going to work this backwards, if I can. The average wear time is north of two weeks. It's in the three-week range. Between two and three weeks, it fluctuates over time. So commissions want to be able to write for the period of time that they want covered. As you know the code requires that the service line work for up to 30 days. I don’t know how you will overcome those challenges. So my guess is your product has to be flexible enough to meet those code specifications. As far as segmenting -- the MCT is used for all Arrhythmias, right. So it’s used for AFib, it’s used for syncope it's used for VTEC. It's most often used for AFib because AFib is the most prevalent Arrhythmias in the marketplace. There is misconception that its used more narrowly. That’s just not true. So put yourself in the position of a clinician, right. You have a patient that is showing symptoms of Arrhythmia. Maybe AFib, maybe something else. Maybe something a little bit more life threatening and time sensitive. You are probably going to want the most accurate device that provides you information in the fastest amount of time. I mean time has a lot to do with luxury -- has a lot to do with convenience. So when we look at it, we look at it in terms of what's best for that clinician and clinicians have different prescribing behaviors. Some do look at what's more comfortable for the patient. Some clinicians have a better handle on symptoms leading to various Arrhythmias, some don’t. But if you have a product line that’s extensive as ours, you can meet all of those needs. And then if you have a product that is accurate as the MCOT with near-real time, turnaround time with results, you can't miss. Right. So our approach is, here are the capabilities, doc. Here is what we would recommend in terms of customer segmentation. But ultimately you are the decision maker and our goal is to give you service capability, flexibility. So that you can do what you need to do for your patient. If that makes sense

Bruce Nudell

Analyst

It does. And just in terms of, just in a thumbnail, like which of the patients that are more likely or better survive telemetry rather than an extended Holter.

Joseph Capper

Operator

Well, again, if you think about what I just said, if you are the patient, what do you want? Do you want the most accurate device, clearly all the clinical evidence supports MCOT as the most accurate device. If you have AFib, it can detect AFib at levels that no other device can detect. And it can do it with a tremendous amount of specificity. This is a device that is accurate up to 100% with a run of 30 second of AFib. Nobody else can make that claim. Do you want that or do you want something that’s accurate to the tune of about 75% or 80%. So you got a 20%, 25% of device calling it wrong. And do you want those results now or do you want them in 30 days. I mean somebody's Arrhythmias are life threatening. We have people that die that are wearing these devices. So we try to get the information back to the clinician as fast as possible. We make emergency calls. We make urgent notifications 25% of the time to our clinicians who are using these devices, starting to diagnose these life-threatening events. I always say to people, look the only drawback to using an MCT versus any other product line is it's a little bit more expensive. If you look at it, the fact that it goes out to 30 days versus 14 or 21, and you do it on a per hour basis, it's probably one of the cheapest devices in the market.

Operator

Operator

Thank you. And our next question comes from Nicholas Johnson from Raymond James. Your line is now open.

Nicholas Johnson

Analyst

Thanks for all the commentary and appreciate all the comments on the extended Holter marketplace. I want to take the opposite. We have seen the ICM marketplace really explode lately, favorable reimbursement. We have seen some new devices being accrued by the FDA. I just want to kind of get your thoughts on kind of the segmentation there between MCT and ICM and whether or not there is anything that you can do on that end to perhaps partner with leveraging your kind of channel and your resources. Thanks.

Joseph Capper

Operator

Yes. That’s been on the market -- I would say it's been marketed more aggressively over the last couple of years. We see it as a complementary product line. A lot of our clinicians will use an external monitor like MCOT prior to using an implantable device. Some insurance companies actually require it now. So we see this kind of complementary. Once you are post-30 days, it's kind of your only choice, right. It's a much more expensive, obviously invasive and a far less accurate device than the MCT. But there is a niche for it, there is a market for it and docs make a lot of money when they implant it. So there is some demand, there is obviously demand for it and it's done well. We think if anything, it's kind of risen the entire market.

Nicholas Johnson

Analyst

That’s helpful. And then kind of going, switching gears to the Apple news that was in November. Now how do you think about that potential, if that study is successful, kind of really broadening the size of the market opportunity ahead of you? Certainly consumers taking more control over their healthcare decisions. I would assume that this could really result in a big surge in the number of consumers going to their GP or cardiologists and asking for information. So how do you kind of frame that opportunity in your mind and when do you think we'll have some level of resolution on that front to make a decision or not? Thanks.

Joseph Capper

Operator

Very difficult to frame. Right. So for the first time in a consumer oriented -- I shouldn’t say the first time but in a large consumer oriented market there is now the ability to detect irregular heart rate and potentially screen for some sort of an Arrhythmia like AFib. So clearly the folks there, the first step is to go and see their doc. So we see it as a potential expander of the market. Don’t know how much, Nick, honestly. Hard to say. But there has been a lot written and a lot of folks have advocated some sort of general screening for Arrhythmia. Specifically AFib, especially when you start to look at segments of the patients population that are more at-risk. So folks with a CHAD score of 3 or above, certain age. You know co-morbid conditions that make them more at risk for Arrhythmia and diagnose -- folks that have been strong advocates for some sort of screening of that patient population. This is a bit broader than that, right. So this isn't today. It's not talking about identifying folks that are at higher risk. It's just a general screening. But I do think they will find some and I do think it will be quite helpful to the healthcare community. If you can -- in my opinion if they avoid one stroke, it's been worth it. That’s just the way I look at it.

Nicholas Johnson

Analyst

Very helpful. And then quickly for Heather. Is there a free cash flow that we should be thinking about for 2018 with the mid-20s EBITDA margin? What type of CapEx are we looking as we think about cash generation of the business in '18. Thanks.

Heather Getz

Management

Yes. No, problem. So we are thinking that when you take into account the increased CapEx and then also we have some one off from the prior year inauguration and restructuring cost like the severance and retention. It's probably in the $40 million to $50 million range.

Operator

Operator

Thank you. And our next question from Marco Rodriguez with Stonegate Capital Markets. Your line is now open.

Marco Rodriguez

Analyst · Stonegate Capital Markets. Your line is now open.

I wanted to kind of take a little bit of a higher level view, if you will, of some of the questions here. Obviously you guys have been doing really well execution wise, the integration of LifeWatch. It kind of sounds like the realization of the synergies that kind of have taken you guys by surprise in terms of the quickness that you have been able to kind of get them. And so is that a fair statement and then if maybe you can talk a little bit about -- Joe, you mentioned in your prepared remarks that you have done a lot of acquisitions in your history and this is by far one of the better ones you have ever seen from an integration standpoint. So maybe you can talk a little bit about what maybe you think kind of drove those types of successes.

Joseph Capper

Operator

Sure. I wouldn’t use the word surprised. I would say pleased. We are highly confident when we went into the integration process that we would get the synergies. And obviously there was a tremendous amount of diligence worked on it in advance to validate that. But once you acquire the company, you move into the integration phase, it's all about execution. And getting a team of folks that are highly focused, and remember we did several acquisitions before we acquired LifeWatch, so we kind of had an opportunity as a management team to work out the kinks. The folks that joined the management team from the LifeWatch side came up to speed very quickly. And so the aggregate management team has, I guess, if there is surprise, I am surprised at how quick they got it and how quickly they got aligned as a team and executed against the priorities. Now I think in terms of best practices, we had a really good approach. We had good structure in place. We had an integration team. We had an integration committee, we had outside help. I think we did it the right way and that’s helped from a timeline perspective, get us to where we are today.

Marco Rodriguez

Analyst

Got you. That’s helpful. And did you perhaps like put in sort of the incentives or any sort of processes that you learned over the years that kind of helped accelerate this.

Joseph Capper

Operator

Mostly process oriented. My opinion has always been, move prudently but move very very swiftly. Have the objectives clearly outlined, communicate as much as you can throughout the organization. Have people who are designated to the assignment, get outside help where you need it. You can't do everything yourself so we got outside help in several different areas, PR, sales consulting, finance, tax. There is a lot of different areas that we got help on. And I think you need to do that. This was just too important. We spent too much of the company's shareholders money to acquire this company to meet a strategic objective that we knew made sense. But realizing that this pace is another thing.

Marco Rodriguez

Analyst

Got it. And then kind of shifting here to the sales and marketing team. Obviously, been doing pretty well here. You called out some impressive statistics here for the team. Just kind of wondering if you could perhaps talk a little bit more as far as how they are sort of being structure since the integration. If like they, perhaps, enter different territories, different geographies. What sort of incentive structure you may have put in pace that might be somewhat different then they had before.

Joseph Capper

Operator

Very similar incentive structure that both companies had in place prior. There is -- in total there is less sales people in the company then there were with the two companies combined. For obvious reasons. That means almost if not, a hundred percent of the people either picked up territory, gave territory to somebody else. And it required a tremendous amount of coordination, hand off and kind of co-selling to make sure that we were able to retain our largest and most valued customers. And I think that’s something that we track quite a bit. And I think they have done a really good job doing that. Some of it is obviously incentive oriented but a lot of it is management direction. So that has gone about as well as I could have anticipated. Things like leaving the legacy brands behind and renaming the organization. So that team that used to market under cardio net LifeWatch will now market under BioTel Heart. Integrating the customer-facing in a very coordinated way. Integrating and transitioning to product labeling and packaging in a very coordinated fashion. All of that is, when I tell you that thousand of line items on the integration task, I am not underestimating. So that has gone as well as can be expected. Now because of that, right, now you have reached in a frequency in the existing territory that you really didn’t have before. Before you had 75-80 reps versus 45-50 reps competing with each other, now you have 100 with the same aligned message, which means better return frequency. A more extensive product portfolio, adopting best practices across the organization. Now products in the pipeline that are about ready to launch. It's pretty darn exciting for these guys. And I can tell you, they are doing an incredible job. This team is producing at levels that I just did not anticipate. Usually you see kind of slowdown of your business when you go through an integration process. There is churn, there is customers that leave you. There is people, there's key employees that leave you. They did a great job managing that process. And let's be honest, that’s the first point of contact in a relationship that customers have with our companies through the sales organization.

Marco Rodriguez

Analyst

Very helpful. And last quick question here for Heather. I am not sure if I missed this on the call or your press release, but effective tax rate for '18, should we model in 21%?

Heather Getz

Management

So the GAAP tax rate, we will still be utilizing NOLs for 2018. So our cash tax rate will be much less than that.

Marco Rodriguez

Analyst

Got you. And where do the NOLs stand right now?

Heather Getz

Management

I don’t remember the exact number but I expect them to be, to start to run out in 2019.

Operator

Operator

Thank you. And our next question comes from Eugene Mannheimer from Dougherty & Company. Your line is now open.

Eugene Mannheimer

Analyst

Congrats on a strong finish to 2017. I wanted to ask about the performance of what I could call non-MCT volumes. Did you -- can you share that with us mid-single digit or whatever it was and any guidance on that going forward. For example, would any theoretical decline in Holter volumes maybe be offset by deliberate conversion of those patients to patches and lifting revenue in that category.

Joseph Capper

Operator

Flattish for Event and Holter is single digit. Event, there was a couple of piece of the business that we walked away from that were there in early -- in '16 and went there in '17. Again, Holter is kind of flat but I think you hit the nail -- I am sorry, Event is kind of flat, Holter is kind of mid-single digits. But I think you hit the nail in the head with Holter because we are seeing probably somewhat of a conversion to the extent that we are Holter.

Eugene Mannheimer

Analyst

Sure. All right, okay. That’s encouraging. And with respect to the earlier comment, Joe, and I appreciate the comments around MCT as the most accurate device whether you are testing for AFib or syncope etcetera. But how does insurance view that. I mean we are hearing from peers that many health plans limit the MCP to second line testing for narrower indications, right. And that extended Holters would be the way to go for first line detection. What is your experience there and can MCT be covered as a first line test?

Joseph Capper

Operator

Yes. Gene, actually the commentary was brought to my attention within the last few days and it's really disappointing. The comments I heard were MCP, insurance companies typically approve it for narrow indications of use like for syncope and VTEC. And that is just a materially false statement. I mean there is -- most insurance companies have broad coverage for MCT. So it's really disappointing to hear that. And the funny, or not funny part was that one of the comments also said that the reason that they do that is because there is a lack of clinical evidence and obviously you know this is coming from one of our peers. And it's ironic because in order to get a permanent CPT code, you are required to show robust clinical peer reviewed evidence. And the MCOT has had a permanent CPT code since like probably ten plus years ago. I mean it's been years since we received a permanent CPT code. The only products in our product portfolio that do not have a permanent CPT code are extended wear Holters which are reimbursed under the same temporary code that the Zio is reimbursed under. When we inquired as to why that was, we asked the bodies in charge of this in the co-setting process, why that was. The response was, at this time there is a lack of clinical evidence to support the issuance of a permanent CPT code for extended wear Holter for that product category. So it's ironic to me that those statements are coming out of a company whose entire revenue base is associated with a single product that has a temporary CPT code and a lot of inherent risk associated with it. MCT has been on the market for several years. It has broad coverage. It has ample clinical evidence. It's the -- clinical evidence is second to none in the category. There has been north of 40 peer reviewed studies published on the product. So it's kind of bewildering that folks are making statements like that. And then there was another comment, I guess, that most insurance companies require the use of a first line monitor prior to the use of MCT, patently false. Some do, some do require it. When they require it, they require a 24-48 hour Holter more often than not. I think the statement was that most require a first line monitor like the Zio patch prior to -- or the Zio Holter prior to the use of MCOT. So I had my folks today do a quick review of all of our MCT contracts and as you know we are the largest MCT provider. We have several hundred contracts and the number of contracts we have that require extended wear Holter like the Zio patch prior to use of MCT was zero. So it's disappointing you have false, misleading statements coming out like that. Folks that are going to get in the MCT market, they should learn it first.

Eugene Mannheimer

Analyst

Got you. Thanks for the commentary there, Joe. Let me switch gears if I could to research services. You know clearly record backlog, that’s impressive. How does that cadence of that backlog though convert? So I mean I assume I takes some time for those studies to rollout and recognize the revenue there. So is the research business going to be more of a second half weighted type of impact in the year.

Joseph Capper

Operator

I think you are going to see decent growth year-over-year through the year for that product category. So when you receive an award for a study, the studies have varying lengths. Some of them last for several years. So we referenced backlog. We are referencing all years backlog. Some of that is going to happen in 2018, a portion of it will happen in the out years. We don’t bifurcate that and make it for public consumption. I will tell you that we are really comfortable coming into this year versus where we were at the same point last year in terms of book backlog. And this is contracted business that you have. Now obviously, some folds out and you add some throughout the course of the year but your backlog relative to your revenue, you can look at historic metrics to get pretty comfortable with where you are coming into the year and what you can expect for the year. So when we say we expect that double digit growth, we are pretty comfortable it's going to happen and it will probably happen gradually throughout the year. It won't be a hockey stick at the end of the year.

Operator

Operator

Thank you. And our next question comes from Mitra Ramgopal with Sidoti. Your line is now open.

Mitra Ramgopal

Analyst · Sidoti. Your line is now open.

Just two quick follow up questions regarding the sales force. Joe, I was just wondering, I know you had mentioned in the prepared comments in terms of growing the business and your top 500 accounts. I was wondering if that was sort of the initial focus coming out of the integration and going forward you will be targeting more new accounts.

Joseph Capper

Operator

We target everything, right. But we put additional focus on our largest accounts. Trust me when I tell you, we are targeting everything. And I wouldn’t get hung up on that. I just thought, I used that metric because I think it's a pretty good indicator of how well the team is doing managing the integration vis-à-vis less insurance than what you might see in less efficient integrations. But we are focused on the whole book of business.

Mitra Ramgopal

Analyst

Okay. No. That’s great. And I know you mentioned, you have I think about a hundred in terms of your reps right now and given the success you are having, are you more inclined to be looking to add or pretty much sort of go through '18 with pretty much the existing sales force.

Joseph Capper

Operator

I think we will look for opportunities to expand where appropriate. As you know we have done that in the past, we don’t add you know 15 new sales people in a year. Our business is a bit more mature than that. So we kind of manage the growth on an organic basis and where appropriate we add resources. Sometimes there are things happening in the market, you might see the expanded payer coverage, it makes sense to put more resources in a certain part of country. There might be consolidation of practices that would dictate a different allocation of your resources. So we are watching at all the time. I think we will probably expand but not like crazy expansion.

Operator

Operator

Thank you. And our last question in the queue comes from Bill Sutherland with Benchmark Company. Your line is now open.

Bill Sutherland

Analyst

Real quick, did I understand correctly the commentary about both the MCOT and also extended wear Holter, as far as being essentially supply constrained right now. And as you get to full capacity production wise, you will be able to meet demand which, I don’t know, kind of implies the growth could pickup from here. Thanks.

Joseph Capper

Operator

Yes. It could, right. So I wouldn’t say somewhat supply constrained. We had to manage the introduction of the product into the marketplace and get appropriate feedback in different stages of product launch, alpha, beta. And then you make changes to the product which take time. So I do think there is going to be high demand for the product, of products I should say. But I don’t want to -- I think we are going to see a pretty good growth. I think we forecasted the addition of those products. We have assumed those products are valuable in our growth. We need those products in order to hit these growth numbers. So I would think about it more on the lines of supporting the growth projections that we put out there.

Bill Sutherland

Analyst

Okay. And then Joe, I am not sure how much you are thinking about M&A these days, but what's the topic or wish list at this point. And is it possible that something maybe on the smaller side because size could happen this year. Thanks.

Joseph Capper

Operator

I wouldn’t put a time on it. So we have never stopped our corporate development activity. We are always looking at opportunities to accelerate our strategic plan and if we can do it through M&A that makes sense, then we do it. Obviously, when you make an acquisition of size of the one we did with LifeWatch, your focus has to be integrate, integrate an get that done properly. Obviously, we are starting to get more comfortable with how that process has progressed or is progressing. So there will probably be somewhat more emphasis on it but I don’t want you to think it's stopped and we will start all over again. We are pretty active in that [co-op dev] [ph] area and I wouldn’t put a timeline on a transaction.

Bill Sutherland

Analyst

Do you think it's more likely to be as far as your strategic initiatives, more in the pop health side or there's really no way to kind of create a rank order there.

Joseph Capper

Operator

I think that could, right. So when we talk about our three priorities, we would like them to be a little bit more balanced then they are right now. Obviously, the acquisition of LifeWatch was once, not once in a lifetime but they are rare opportunities that you can merge two like kind assets, accelerate a growth and realize the synergies. So that was a deal that we wanted for a long time. We like the research business. It makes sense for us to look at additional services there. And obviously pop health or connected health, it's all still developing. I am sure we have talked about this in the past, there is not many examples of companies that have built connected health business models like ours that are past the mom and pop phase and profitable. Some of them are growing real fast but there is no profitability. I am not sure how big the markets are going to be. I personally think, these markets are going to be very very large and they are going to integrate more into general healthcare and less kind of segmented. But in the near-term they will probably be somewhat segmented. So we like pop health, we like research. In a perfect world, they would be the priorities for me. But there is other areas that we are looking at as well. So I would say the theme throughout all of our market development, corporate development activity is connected health. To the extent that we can build businesses that leverage technology in such a way that you can monitor, diagnose, treat, patients outside of the four walls of a hospital or another expensive infrastructure, pushing out the healthcare infrastructure and treat these folks and monitor these folks remotely with technology. It just makes sense, right. And we think that’s the right size of the equation to be on and that’s how we do our business. So we will run the connected health theme through everything that we do and the opportunities that we just talked about, the three markets that we are in today, we like. But I think there is other opportunities as well.

Operator

Operator

Thank you. And I am showing no further questions in the queue at this time. I would like to turn the call back to the speakers for any closing remarks.

Joseph Capper

Operator

Thanks, everybody. Well, that concludes today's call and we will talk to you at our next call. It's a shorter period since we had a longer period this time. So we will talk to you in a few months. Operator, that concludes today's call. Thanks, everybody.

Operator

Operator

If you joined the conference late today, you may listen to the conference call via digital replay which will be available through the Investor Information section of the BioTelemetry Web site at www.gobio.com, until Thursday, March 8, 2018. This concludes your call and you may all disconnect. Everyone have a great day.