Earnings Labs

Cross Country Healthcare, Inc. (CCRN)

Q1 2018 Earnings Call· Fri, May 4, 2018

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Transcript

Operator

Operator

Good morning ladies and gentlemen, and welcome to the Cross Country Healthcare Earnings Conference Call for the First Quarter of 2018. This call is being simultaneously webcast live. A replay of this call will also be available until May 17, 2018, and can be accessed either on the company's website or by dialing in 866-443-8011 for the domestic calls and 203-369-1122 for international calls and by entering the pass-code 2018. I will now turn the call over to Chris Pizzi, Cross Country Healthcare's Chief Financial Officer. Please go ahead, sir.

Chris Pizzi

Management

Thank you and good morning everyone. With me this morning is our Chief Executive Officer, Bill Grubbs; and our Chief Operating Officer, Bill Burns. This call will include a discussion of first quarter 2018 results as disclosed in our press release and will also include a discussion of our financial outlook for the second quarter of 2018. After our prepared remarks, we will open the lines for questions. A copy of our press release is available on our website at www.crosscountyhealthcare.com. Before we begin, we need to remind you that certain statements made on this call may constitute forward-looking statements. As noted in our press release, forward-looking statements can vary materially from actual results and are subject to known and unknown risks, uncertainties and other factors, including those contained in the company's 2017 annual report on Form 10-K and quarterly reports on Form 10-Q as well as in other filings with the SEC. I would encourage all of you to review the risk factors listed in these documents. The company undertakes no obligation to update any of its forward-looking statements. Also, comments made during this teleconference reference non-GAAP financial measures such as adjusted EBITDA or adjusted earnings per share. Such non-GAAP financial measures are provided as additional information and should not be considered substitutes for, or superior to, financial measures calculated in accordance with U.S. GAAP. More information related to these non-GAAP financial measures is contained in our press release. Lastly, in order to facilitate a better understanding of underlying trends, we may refer to pro forma information on this call, giving effect to acquisitions and divestitures as though the transactions had occurred at the start of the periods impacted. As a reminder, we completed the Advantage RN acquisition effective July 1, 2017, and the results of its operations have been included in our reported results beginning with the third quarter of 2017. With that, I will now turn the call over to our Chief Executive Officer, Bill Grubbs.

Bill Grubbs

Management

Thank you, Chris. Thank you everyone for joining us this morning. This was a good quarter for us, starting the year off stronger than originally anticipated with revenue growing in all 3 of our reporting segments and improved cost management, our adjusted EBITDA exceeded expectations. The strong start to the year gives us a good foundation to build on and even though we still have some work to do, we believe we will show a year-over-year improvement in our financial results for the full year. Before going into more detail on each of the businesses, I want to provide an update on the headwinds we faced on the fourth quarter of last year. The headwinds came from the impact of hurricanes in September, a lower renewal rate or a pullback in spend from certain large customers, and a lower percentage of our billable hours for premium rate business. Let's start with the travel nurse impact from the hurricanes and from the reduction in renewal rates. Both of these events resulted in the base number of nurses out on billing for travel nurse to be reduced. Because of the historical nature of travel nursing, it takes a while to grow back to previous levels when a step change like this occurs. Now, obviously the impact from the hurricanes was an isolated event and we've also not seen any further pullback in spend from customers in the first quarter. Therefore, we expect to return to the previous levels in travel nursing by the second half of the year. I was originally going to wait until the Q&A to talk about the specific numbers related to the full impact and the progress we've made, but I think adding that color here is probably important. So I'm going to go over some numbers and…

Bill Burns

Management

Thanks Bill. As I mentioned last quarter, my focus is on driving revenue growth and identifying opportunities for achieving operational efficiencies and improved productivity. Over the last several months I spent time working with each of the businesses and visited several of our large customers. I remain encouraged by the opportunity that lies ahead for us as we continue to grow the business and increase our market share. Let me start with revenue growth. As Bill mentioned, we exceeded our expectations for the quarter. Now I'd like to share a little more color on some of the key drivers as well as some of the opportunities to accelerate growth. We saw a strong year-over-year growth in the areas of travel allied, education healthcare staffing, advanced practices and [retained] search. Travel nursing reported year-over-year growth which was due the impact from the Advantage RN acquisition in mid-2017. On a pro forma basis, revenues were down to travel nurse due to the lower number of healthcare professionals out on billing, that's the impact Bill was mentioning a moment ago, as well as the impact in the shift in mix from premium rate orders. So the business started the year off slowly due to the headwinds we mentioned a moment ago. We continued to improve throughout the quarter with a growing number of healthcare professionals out on billing. Renewal rates which had declined in second half of 2017 and most notably in the fourth quarter have steadily risen during the first quarter and as we proactively managed assignments, schedules and in the coming weeks. Travel nurse will continue to lag as we proceed into the second quarter, but should rebound as we progress throughout the year. The opportunity to grow as fast or faster than the market remains largely due to the strength…

Chris Pizzi

Management

Thanks Bill. I'm pleased with our overall financial performance this quarter as we experienced year-over-year revenue and contribution income growth across all three of our business segments. We exceeded our guidance ranges for revenue, adjusted EBITDA and adjusted EPS and our gross profit margin was within our guidance range. For the quarter total revenue was $210.3 million, up 1% from the prior year and down 4% sequentially. The year-over-year increase was primarily due to the Advantage RN acquisition offset by declines in our legacy travel nurse business resulting from fewer overall placements and lower renewal rates on existing nurses. The sequential decrease was primarily due to normal seasonal trends for this business as well as fewer placements mainly in our nurse and allied and physician staffing businesses. Gross profit margin for the quarter was 25.6%, down 10 basis points from the prior year and down 90 basis points sequentially. The sequential decline was primarily due to the impact from the annual payroll tax reset which we experienced at the beginning of each year. Moving down the income statement, SG&A for the quarter was $45.6 million, down 3% from the prior year despite adding $3 million related to the Advantage RN acquisition. SG&A was down 1% sequentially primarily due to the cost-savings initiatives completed over the past couple of quarters. As discussed earlier in our year-end earnings call, we are focused on achieving an adjusted EBITDA margin of 8% as we exit the fourth quarter of 2019 on a run-rate basis. Well, this target is not the endgame, it is an important milestone for us and it is dependent upon executing on our organic growth strategies in addition to the cost savings initiatives discussed earlier. During the quarter we incurred a restructuring charge of $400,000 in connection with our cost-savings initiative.…

Operator

Operator

We will now begin the question-and-answer session. [Operator Instructions] Our first question comes from Jeff Silber from BMO Capital Markets. Your line is now open.

Unidentified Analyst

Analyst

It's [Henry Chen] calling for Jeff. Just a question on the 2Q guidance, just want to make sure I'm understanding this correctly. So it seems like revenues is there, it should at least stay flat sequentially and there's a chance that it could decline year-over-year. I just want to understand is that primarily due to the drop in assignments in travel nurse offset by steady revenue growth on the other businesses, and I'm just trying to understand how to think about that potential decline?

Bill Grubbs

Management

Yes, it's certainly is the result of the headwind from Q4 where we're still trying to grow back into the level of headcount on our billing for travel nurse and that's the biggest impact. We expect executive and physician search to do -- to have another good quarter and there will be a little bit of decline we think in physician on a year-over-year basis because we had a good quarter last year. So it's a bit puts and takes here and there, some of it within Nurse and Allied with physician -- sorry, with education still growing and travel allied will still grow. It's puts and takes here and there, so it looks like it's kind of flat on the sequential basis and either slightly down or slightly up on a year-over-year basis.

Unidentified Analyst

Analyst

And on the nurse side the decline in billing rates, is that primarily due to the impact from the premium rate business or is sort of like...

William Grubbs

Analyst

It's almost all completely due to that, yes.

Unidentified Analyst

Analyst

And shifting over to the cost side, the 3 million to 3.5 million that you've targeted that's expenses that you're targeting to be removed this year and then the additional 3 million to 4 million and 15 million that Bill mentioned earlier, that's incremental on top of that over the next few years?

Bill Grubbs

Management

No, the amount this year is part of the total 15 million and Chris was relating the restructuring charge to 400,000 in the first quarter to the 3 million and 3.5 million. We think we might be able to get a little bit more than that total out of this year, maybe 4 million, maybe a little more than 4 million for the full year and then next year maybe $8 million to $9 million total for the full year, but be at a run-rate of the 15 million maybe by the fourth quarter of '19. Is that right, Chris?

Christopher Pizzi

Analyst

That is right.

Operator

Operator

Our next question comes from A. J. Rice from Credit Suisse. Your line is now open.

A. J. Rice

Analyst

Couple of questions if I might. First of all just -- and I know we talked a little bit about this last call, so this depth in volume and placements, remind me, are you attributing that mostly to the way the market is reacting coming out of the gains in the issues in the third quarter, are you sort of attributing that mostly to your own internal disruptions that you experienced in the sort of rebuild the order-book in the recruiting and so forth?

Bill Grubbs

Management

Yes, there may have been some minor disruption to our customers that were in the hurricane areas like in Florida, but that was not -- that was a minor part of it. It was really the fact that our travel nurse operation is based here in South Florida and we were closed for several days and then we had power outages and Internet outages and travel restrictions and schools closed for a couple of weeks afterwards. And it was that disruption that really was the driver of not being able to make the normal levels placement. And as you know, once you don't make them, somebody else made them and you just don't get them back again.

A. J. Rice

Analyst

And so you would say the -- your sense about the underlying tone on travel nurse segment just financially is still pretty robust, I don't know if you have a metric of positions filled, open or filled or whatever that would -- on your MSPs, give a sense of how you perceive the underlying tone of the overall market to be?

Bill Grubbs

Management

Yes, so I'll make a short comment and I'll let Bill make a comment on how it kind of manifest itself. So dropping 550 people out on billing for the beginning of a quarter to the end of a quarter is a huge amount of heads-on billing for us. That's a step change that doesn't normally happen. And I'll let Bill explain how it comes back again and why it takes so long.

Bill Burns

Management

Yes. So two things, one to just follow up on Bill's point, so you only have the capacity to do so many assignments and clocks in a particular week. And so we're certainly seeing the headcount rise steadily throughout the first quarter, but it's just very difficult to increase and try to cover that kind of a gap in a very short period of time. It's the timeframe of getting people through the pipeline, getting them submitted, getting them interviewed at the hospital systems, the capacity and then with the teams here to do all that work. So there's a kind of a constraint on how fast you can bring it all back. But there was another point I was going to make and I've just forgotten it.

Bill Grubbs

Management

Well, let me word it slightly different than Bill did. There was a step change in our billable headcount, but you can't just automatically make a step change in the number of placements you make each week. So we can't automatically start making an extra 50 placements a week to try to make up for the 550 that fell off because if we could have done that, we'd have been doing that already. So production is back to normal, but normal production is only going to grow so much every week until we get back to all 550.

Bill Burns

Management

That's right. And then you had asked about do we have forward-looking metrics and we do obviously track order volume, order counts. Throughout much of '17 as the clients were pulling back on spend, we did see orders coming down. That sort of stabilized as we left and entered into the first quarter and it's kind of held steady at a reasonable rate now for -- to continue to grow, it's not back to the lofty days of '15 and '16, but nevertheless it still seems to be fairly robust enough for us to grow.

A. J. Rice

Analyst

And then I appreciate all the comments about the cost-reduction programs you have in place. To get to the 8% margin by yearend '18, do those cost reductions pretty much get you there? Do you need an acceleration in year-to-year revenues and sort of what order of magnitude would you need to get to the 8% margin?

Bill Grubbs

Management

Yes, so by the way, it's the fourth quarter of '19, not '18.

A. J. Rice

Analyst

I mean '19, sorry, yes, I know.

Bill Grubbs

Management

Just want to be clear. No, there is a page in our Investor Presentation that will be posted. Well, the old one has it as well. The new one actually has the dollars associated with it that will be posted either today or tomorrow on our website. And it talks about -- it talks about, we need about $23 million -- I think $23 million in increased profitability on annualized basis by the time we get to the fourth quarter of '19. $15 million comes from cost-cutting, $7 million or $8 million of it comes from what we believe we'll be able to grow at mid-single-digit numbers once we get past these headwinds.

A. J. Rice

Analyst

And then my last question just is just around the systems reconfiguration you're doing. I know you said in the second quarter you've got a little vacant for disruption there. I guess I'm trying to understand how disruptive is this? Who is going to experience the disruption? And do you think -- how much risk is associated with rolling this out? Sometimes system conversion rollouts can cause more disruption than is expected.

Bill Grubbs

Management

Yes, there's a couple points to make. One is over the last few years we replaced the front office recruiting systems in all of our businesses in the company except travel nursing. So this isn't a completely new process for us and I think we understand the pitfalls. Secondly this is an 18-plus month project, the actual implementation of it wouldn't be till the second half of '19. We don't anticipate any disruption. Well, we don't anticipate any disruption at all. If there was going to be disruption, it would be in the second half of '19 when it starts to roll out. But we believe we have a very good IT partner, we've hired a change management organization to support us. I think the management restructure that we made in January will help support it as well and we're going to phase it in using different business segments that we won't go big bang. So we'll be able to identify whether there are issues or not and whether it's performing the way we expect it to. We believe we have a very good process here. As you know, we had started this project a couple of years ago, and I pulled the plug because I didn't think it was going to be successful. I'm very confident that we're on a good track here. But we won't really implement it till the second half of '19. It's really development from here until then.

Operator

Operator

Our next question comes from Brooks O'Neil from Lake Street Capital Markets.

Brooks O'Neil

Analyst

So Bill, I am just trying to be sure I understand what drove that step function decline in your travel nurse business. Obviously my sense is hospitals are doing pretty well, there was a strong flu season. Just help us understand was this an industry phenomenon, was it an anomaly of a few of your hospitals or is it something related to your core business?

Bill Grubbs

Management

No, it's not related to our core business. We think everything is generally on track. Our production is pretty good. Our orders, as Bill said, are fine. The bulk of it was the impact of the hurricane. And our travel nursing business is based in South Florida and at the beginning of September of last year we had to shut down. And if the recruiters can't get online and can't make phone calls to their healthcare professionals, then we just lose a bunch of placements. And that drop off from the end of Q3 to the end of Q4 of 550 was mostly the result of not being able to make the placements during the disruption from the hurricane. And then a little bit of some pullback at a couple of big customers that we have not seen continue on into Q1. So it seems like it's unique to us and it seems like kind of isolated incidences that are not recurring and once we build it back up to the level we had prior to the step change, I think we're in good shape.

Brooks O'Neil

Analyst

Could you just give us a quick rundown in terms of Advantage RN integration? I'm kind of thinking there should be more left in the business related to that acquisition. And for whatever reason I'm not positive I've seen it. So help me to think about that.

Bill Grubbs

Management

Well, as we said they're doing a great job in filling our MSP jobs. We feel that we've got -- if you remember we first acquired the company July of last year. The first quarter we had, we didn't get what we wanted out of it. We fixed that and had a good fourth quarter and an even better first quarter. So I'm not sure exactly -- we had said originally when we acquired the company that the deal wasn't done on synergies, it was done on their ability to have a different operating model and to be able to deliver to our MSPs. So we really weren't building any integration synergies into the deal. But we -- there are some opportunities to leverage functions that exist across all of our businesses, whether it's credentialing or payroll and billing or other functions that we will look at and get over time probably built into a total $15 million cost-savings, but nothing significant from an integration standpoint.

Brooks O'Neil

Analyst

And then I think somebody talked about the managed services business, but you're still seeing that growing robustly and do you still think there's significant opportunity in that area for you as you go through 2018 and beyond?

Chris Pizzi

Management

Yes, the pipeline for deals is still very strong. I don't know that we'll continue the rate and pace we saw from '16 and '17. We obviously had tremendous number of wins in both of those years. We're off to a good start this year, but as Bill mentioned on the call, if you look at the amount of spend yet to ramp plus new wins, it's still close to $100 million of opportunity for us just to take that and grow into it and get our usual capture of that, plus we do continue to expect to win a couple of MSPs per quarter going forward. So the opportunity is still there, it's definitely a big area of focus for us. We're looking at how we continue to expand our service lines at the MSPs as well and ensuring that we're bringing Allied to the table and physician staffing and the like. So we do think this is a very big opportunity for us.

Bill Grubbs

Management

Plus the capture rate.

Chris Pizzi

Management

Plus the capture rate, moving that up, right.

Brooks O'Neil

Analyst

And then the last question for me, in the past I've always had a sense that the education market was a reasonably good-size opportunity for you guys. It's not something I hear about from the others, but could you help us understand how big an opportunity you think that is and whether that continues to grow robustly as it has in the past?

Bill Grubbs

Management

Yes, I do think it will continue to grow. When we acquired Mediscan at the end of '15, the school business was only about $20 million. It's doubled now -- organically in the last couple of years, so we're very pleased with that. We do think that -- I don't know if we have -- we did hire a consultant to do some analysis and give us a view as to where the opportunities were across the nation, I don't remember what the total dollar opportunity is, but -- I have it in the presentation somewhere, I'll try to dig it out and make it available, but we think it's significant, we think it's an underserved market, there's not a lot of competition and we seem to have a good differentiation and a good model that we can build on. So we're looking at both organic expansion, as well as potential acquisition expansion, if we can find some opportunities.

Operator

Operator

Our next question comes from Kevin Steinke from Barrington Research Group. Your line is now open.

Kevin Steinke

Analyst

So there were some discussion throughout 2017 on your calls about just some general uncertainty in the demand environment around customers having some hesitancy to commit to new travel nursing assignments due to uncertainty around the Affordable Care Act and do we feel like that kind of market pause is completely behind us now and customers are committing to new assignments at normalized rate?

Bill Grubbs

Management

Yes, I -- yes and no. Things seem to be back to normal trends and customers seem to -- buying behaviors seem to be back to where they were before generally from how they behave, but we are getting a lot of requests in our quarterly business reviews with our customers to help them find a way to be more efficient, save money, maybe speed up the time it takes us to get nurses or healthcare professionals on site. They have their own challenges. I'm encouraged by the recent hospital reports that show patient numbers are up and profitability is up and I think that helped to calm things down in the market, but we still get some pressure to help support, not really asking for price cuts, but they're asking for us to help them become more efficient and better at it. And I think that that's a good sign for us and I think it's why we're seeing such a big take-up in these managed service programs, because managed service programs automatically create efficiencies and cost-savings for our customers and I think that's why we've seen such a big uptick over the last couple of years. But generally yes, things seem to have settled down.

Kevin Steinke

Analyst

And just following up on the Advantage RN discussion, how much did they really contribute to that sequential improvement in the capture rate, and how much capacity is left for Advantage RN to continue driving their capture rate higher?

Bill Grubbs

Management

Yes, so if I look at the numbers here, so Chris, if I look at these two numbers, so this one and this one, so what percentage of that is 2% of the total capture rate --

Chris Pizzi

Management

Right, probably a couple of hundred.

Bill Grubbs

Management

Probably 2%, couple of hundred basis points came from Advantage RN and the increase in our capture rate. Is that right, Bill?

Bill Burns

Management

That's about right.

Bill Grubbs

Management

Okay. I [indiscernible] my math is right. So we're very pleased with that. So that is one of the ways that we believe that capture rate is going to go up, after they've proven that they're more nimble and more flexible than our old legacy system and that we can continue to help drive that up. I forgot what the second part of the question was.

Kevin Steinke

Analyst

No, yes, just how much capacity they have to continue contributing to that higher capture rate?

Bill Grubbs

Management

Well, I'll let Bill answer that. I feel he spent a week there a couple of weeks ago and I've said, I want to build on this, what do we have to do to invest and build on the successes we've had, so I'll let Bill answer that.

Bill Burns

Management

Yes, they've got a very concerted effort and focus on aligning the account managers with our MSP programs. There's a focus at the desk level to ensure that the submissions are continuing to be funneled to the MSPs as much as possible. I do want to stress that they do have a core amount of business that's outside of our MSPs. We're looking to protect and preserve that as much as possible, we obviously want to keep that and grow with our MSPs.

Bill Grubbs

Management

This isn't an either/or.

Bill Burns

Management

This is not an either/or, so we want to continue to retain their book of business that they have, but there's a very big focus on continuing to ensure that we're moving to the MSP programs, we've broken down a lot of the barriers and things that might have been challenges if only first at the deal they were sort of being handled as though they were still a subcontractor to us a third-party and that's no longer the case, the information is flowing a lot better and...

Bill Grubbs

Management

Based on what the target is for the year, we probably are targeting about a 200 basis point improvement from their involvement, MSPs for the next 2 quarters.

Bill Burns

Management

Yes, sequentially, yes, I would agree with that.

Kevin Steinke

Analyst

And then lastly you mentioned your efforts on candidate attraction and conversion so can you just provide us un update with what you're doing there now and how far along you are, and I believe you said that could contribute to the improvement growth as we move forward, so maybe the expectations is how they can contribute?

Bill Burns

Management

I mean, there's a lot of things that, we won't get into the all the nitty-gritty details on this call, but there's a lot of things that we've been doing first and foremost to review our own processes for ensuring that we're making sure we're moving the candidates through the process as efficiently as possible that we're not over-credentialing et cetera. We're looking at the tools at the desk level to ensure that our recruiters have the ability to do analysis and be able to give data live on the call with their candidates so that they're not hanging up from them and having to call them back. So we're looking to speed up the process to getting the candidate conversion moving by having the better tools at the desk level and better flexibility for the recruiters. So those are couple of the things. We obviously always look at our mix of spend and where our candidates are coming from ensuring that we're getting the most cost-effective and efficient sources, so, some sources are identified to have lower conversion rates. We'll start to pull back and travel back from that and really emphasize where we're getting better conversions and better quality.

Bill Grubbs

Management

And I'll add to that as well, we had a big technology push also in the ways that we communicate with our candidates, that we do a lot more online chatting with them, so that our recruiter can engage with multiple candidates at one time, we do more texting and we have a portals for them to access information so we don't have to run around to gather data for them that they can access it themselves. So as Bill said, we're -- it's process improvements, but also improving the candidate experience.

Operator

Operator

Our next question comes from Tobey Sommer from SunTrust Robinson Humphrey.

Tobey Sommer

Analyst

Could you describe changes in order levels in '18, not just in the quarter, but maybe if you could include April in terms of what you're seeing and I have travel nursing in mind.

Bill Grubbs

Management

Yes, I don't have it in front me right now. I mean I think as I mentioned earlier, we saw a downward trend through much of '17 on the order volumes, both MSP and non-MSP. Going into Q1 of '18 that has -- that deceleration has not been there..

Chris Pizzi

Management

No, we had an increase from Q3 to Q4 though.

Bill Grubbs

Management

We did, slight increases as it leveled off coming out of the year, but certainly going into the first quarter of '18, the orders have held up. I don't think we've -- they're not markedly up or down, it's kind of been in a…

Chris Pizzi

Management

Same, steady, yes.

Bill Grubbs

Management

..stable state.

Tobey Sommer

Analyst

What were renewal trends like in travel nursing in the quarter in April?

Bill Grubbs

Management

The renewal rates have continued as I mentioned continue to rebound. They were -- they're always seasonally lowest in the fourth quarter, so that's one thing, but they were down…

Chris Pizzi

Management

They were down way below...

Bill Grubbs

Management

..way below where we had expected in the fourth quarter of '17. The numbers have rebounded, I'm going to probably say 500 basis points or 600 basis points sequentially going into the first quarter and are up sequentially again going into the second quarter as we're looking...

Bill Burns

Management

And they're near all-time high.

Bill Grubbs

Management

Yes. And we've had several weeks now of all-time high. It is a big focus of area for us. We are proactively managing the assignments as they're coming up for end making sure that we're working with the client to get the orders as quickly as possible to renew the healthcare professional. They just don't -- they're not -- if you wait too long, they're going to move and go off somewhere else, so we're trying to get the renewals in as fast as we can and obviously it improves our productivity the sooner they get those renewal orders that they can start to focus on converting new locks.

Tobey Sommer

Analyst

What's the recruiter headcount like on a year-over-year basis? Has it been gross, just kind of wondering in the face of the revenue decline what the kind of sales related staff headcount looks like? And maybe if you could speak about it with and without the impact of acquisitions?

Bill Grubbs

Management

It's a little harder. I mean recruiter headcount is certainly down as the year progressed, it's at a level of -- we still have the capacity to grow, we're going to be continuing to invest in that. I think if you looked on a reported basis, it's probably closer to flat when you include Advantage with our legacy travel nurse business to where we were prior to the acquisition when revenues were a bit stronger.

Tobey Sommer

Analyst

And how do you handle the fourth quarter kind of rough patch related to the weather and impaired productivity? Did you experience turnover in the recruiters or did you kind of make a decision as a company to make them whole for that lower revenue run-rate and commission that they kind of weren't able to achieve for reasons outside of their own control?

Bill Grubbs

Management

Yes, I mean, there's some things we do internally that we're probably aren't going to talk about on an open call, but it wasn't a big issue generally. And we did not have any more turnover than on our normal trends because of the headwinds. Everybody was focused on trying to get back again, so we didn't see any major disruption from that at the staff level.

Tobey Sommer

Analyst

And last question from me, from an M&A perspective, does the slight repurchase in the quarter signal a different appetite for M&A and if not, have your areas of focus changed at all?

Bill Grubbs

Management

It does not. I still would like to do some acquisitions, the board is behind it, but the share price was so depressed and we're generating as you know we had, what was it, $45 million of operating cash flow last year, $13 million in the first quarter, we feel pretty good that we have enough money to do some share buybacks and not eat into what we have available to do an acquisition. So we still have $115 million revolver that's unutilized today and I think we had cash at the end of the quarter about $33 million plus the $115 million, so I think we're okay, because we're not going to spend $10 million or $20 million on share buybacks, but if we're trying to offset dilution from share grants we might do 200,000 or 300,000 more shares at some point, but I think that gives -- still gives us enough dry powder to do an acquisition.

Operator

Operator

Our next question comes from Mitra Ramgopal from Sidoti & Company.

Mitra Ramgopal

Analyst

Just had one question, I just wanted to get a better sense in terms of the benefits we should expect from the -- on the margin, on the cost-saving initiatives relative to investments you probably still have to make in terms of building out infrastructure to grow the business. I know you talked about the technology push etcetera and I was just curious in terms of how much more investing you have to do on that side to support the step-up in the MSPs etcetera?

Chris Pizzi

Management

So the $15 million of cost savings is net of investments that we would need to make as well.

Bill Grubbs

Management

Well, those three buckets are in isolation, the organic growth number is net of investment [Indiscernible]. But it assumes that we're going to continue to make normal investments in the business to grow whether that's in revenue-producing heads or in technology. Not necessarily the project for the Irish replacement, that's still not modeled in there.

Mitra Ramgopal

Analyst

And then just as a follow-on in terms of investments you're making, is there -- I don't know if you could give us how far along you're in that, if that will continue well into 2019 or you expect to get most of it done this year?

Bill Grubbs

Management

The IT investments or other...

Mitra Ramgopal

Analyst

Yes, the IT.

Bill Grubbs

Management

Yes, so the IT is total of $10 million to $12 million, Chris, 80% of it we think will be capitalized, that we're not sure...

Chris Pizzi

Management

Yes, we have not finalized the agreement, but...

Bill Grubbs

Management

-- either capitalized or deferred or [indiscernible].

Chris Pizzi

Management

Correct.

Bill Grubbs

Management

Look, when we have all the details about the phasing and what's capitalized or deferred and what's P&L, we'll come back and make sure everybody's aware of it, but because it's not finalized yet it's really hard to nail it down. So I apologize -- we don't have it yet until we know for sure that -- what the contract says, what the accounts say is the right accounting for it and how it's going to phase it.

Mitra Ramgopal

Analyst

And then quickly on the tax rate, how should we view that going forward?

Chris Pizzi

Management

So we are looking, as I mentioned, for a 200 basis point reduction in the annual income tax rate for the year, but right now we're at about a 35% effective tax rate for the next couple of quarters.

Bill Grubbs

Management

We hope to get it down to about 33%.

Chris Pizzi

Management

Hope to get it down to 33% by the end of the year for the entire year of '18 and then into '19 I would use the same rate.

Operator

Operator

Our next question comes from Jason Plagman from Jefferies. Your line is now open.

Jason Plagman

Analyst

So following up on the order trend discussion, with -- did you see any difference in the order trends between MSP and non-MSP demand in the market?

Bill Grubbs

Management

Yes, see, we look at that every week. I think MSP orders are slightly up, slightly ahead over the general market, but not a huge swing.

Chris Pizzi

Management

No.

Jason Plagman

Analyst

And then on the MSP pipeline, what's the mix there of Greenfield opportunities versus displacement opportunities? Just wondering if you're seeing new clients adopt -- looking to adopt MSP or just the mix between new opportunities and displacement?

Bill Grubbs

Management

Yes, so in '16 and '17 a high percentage of the wins we had were completely new customers that had never had a program before. We look -- I look at the pipeline every week, if I had to put a guess, and this isn't scientific, but it's probably more 50-50 now of new Greenfield sites versus existing opportunities where someone's looking to make a change from another vendor. Bill, do you...

Bill Burns

Management

I'm just looking at the wins we reported this year. It's...

Bill Grubbs

Management

Exactly that way, so.

Bill Burns

Management

So like -- just coming into the year, the two that we talked about are Greenfield, they were not...

Bill Grubbs

Management

So everything we won so far this year is Greenfield. But there are some decent opportunities from customers that aren't happy with their existing vendor and that may make a difference going forward, but it's still a good mix of both Greenfield and existing opportunities.

Jason Plagman

Analyst

And those displacement opportunities, are those primarily vendor-neutral MSPs or are they staffing led?

Bill Burns

Management

It's a mix.

Jason Plagman

Analyst

And then last one from me, the MSP kind of opportunity on ramping up implementation there, that's kind of hovered around $70 million for the last few quarters. What would you say has kind of prevented you from bringing -- making material progress on bringing that lower and getting those MSPs ramped up that you've signed over the last 12 to 18 months?

Bill Burns

Management

Yes, it's a little deceiving because it was $70 million and we actually billed some of that 70 million, but then new ones are coming on and bringing the level back up to 70 million, so it's not the same 70 million that's just staying flat. No, no, we increased some of them and then new ones are coming on at the same time. So don't read it as we're not doing anything to stay stagnant. It just happens to be the same number that the new ones coming in have offset what we've increased. So we are making progress. We are moving all of those forward. We track it very, very closely and I think we've made the statement before, if you go look at '15 and '16 and what happened in '17, usually the number we think it's going to get to, we get to. We're very good at predicting what the spend is going to be. So I fully expect that that 70 million will ramp as well as the 20 million that we won in the first quarter and then we'll end up at whatever -- hopefully our capture rate by then is 65% to 70% and that will show off in our numbers as they fully ramp. But, no, that 70 million is not the same $70 million as was last quarter.

Jason Plagman

Analyst

I was just wondering eventually can I get 40 million or 50 million just a couple of quarters worth of MSP wins, six months worth of MSP back logger should we expect it to remain kind of similar to [indiscernible] levels?

Bill Grubbs

Management

Yes, I guess it depends on how much we win and how quickly they get implemented. It's hard to predict. 70 million to 100 million, is that the high-end of where I think it will normally be. It probably will come down a little bit especially as we increase our capture rate and get these things ramped.

Operator

Operator

Our final question comes from Bill Sutherland of The Benchmark Company. Your line is now open.

Bill Sutherland

Analyst

And it is literally one question. Bill Grubbs or Burns, you can help [technical difficulty] at least the mechanic of the recovery, the travel, placements [technical difficulty] to the revenue for the [indiscernible]. If you've added back half of the [indiscernible]-- so end of last month and do sequentially is [technical difficulty]-- the second quarter, I guess I'm wondering about just the mechanics [technical difficulty]-- maybe that's already focused, may I understand this?

Bill Grubbs

Management

Yes, you broke up a little bit, but I think I got the question. I on purpose gave the data points at the end of the periods because that's really what the challenge is for us is -- but how it comes out in a quarter, so I'll talk about the fourth quarter of last year. We actually had a good October in the fourth quarter of last year and most of the 550 dropped off in November and December, so the average for Q4 wasn't terrible, but that doesn't really tell the story. And the revenue you see is based on the average, not on the ending point. The ending point is where the pain is at ending at 550 below where we ended Q3 and so we wanted to kind of give you what the full challenge was and how well we've done against that which is going back half. But how we grew back that half phased in over January, February, March and April, we're not disclosing how it came in and what that -- I mean, you could tell what the average is generally in Q1, so it's hard to relate it to exactly what the revenue is within a month or within a quarter because it really depends on how it phased in. But the message we're trying to say is that, look, it was a big number from Q3 to the end of Q4. We've gotten a bunch of it back again and we think we're going to continue that and get it all back again in the next three or four months and then we're back to where we were before which is a good thing for us. I hope that answers the question.

Bill Sutherland

Analyst

So I guess what I can surmise is that the recovery is more towards the April-end of that period and January and therefore the -- this impact on revenue in the second quarter is not going to be as meaningful? Is that...

Bill Grubbs

Management

Yes, it's certainly not linear and so it is hard to extrapolate it exactly the way with each of those data -- I mean the endpoint data, but, yes, certainly January started out very low and as a result -- so you're right, it won't have as much of an impact in Q2 because of what you just said. Okay. Well, I think that concludes our prepared remarks. At this point we'll be back again in August to talk about our Q2 and Q3 guidance. Thanks everyone.

Operator

Operator

A replay of today's conference will be available through May 17, 2018. You may access the replay by dialing 1866-443-8011 or 1203-369-1122. Please use the pass-code 2018. Thank you for joining. You may now disconnect.