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With this strong start to the year in many areas of our business, we are well-positioned to achieve our full-year 2019 guidance targets for continuing operations, which we communicated back in February, and which includes the results from our non-controlling interests. With that, I'm going to turn the call over to Stephen to walk you through our first-quarter results in detail. Stephen?

Stephen Lieberman -- Chief Financial Officer

Thank you, Julie, and good morning. Turning to Slide 4, you will see that we produced very strong results in the quarter. RBR of $186.1 million was up 15% year over year driven by a rebound in healthcare consulting, continued strong demand in our energy segment and strong contribution from the managed services business, led by the contribution of strong operating performance of our HSS joint venture. These revenue gains translated into higher profitability in the quarter with adjusted EBITDA up 77% year over year to $16.3 million.

Performance in the healthcare segment led the way with strong consulting demand, driving utilization improvements and HSS producing strong operating results including the recognition of performance-based fees. These impacts more than offset under performance in FSAC, which I will discuss shortly. On the administrative side, G&A was favorable driven primarily by lower bad debt in the current year period. As a percentage of RBR, G&A excluding bad debt improved nearly 320 basis points year over year to 18.7% of RBR.

Although we continue to maintain resources to support the TSA with ankura, we remain confident in our ability to continue to gain G&A leverage and still anticipate G&A, excluding bad debt to be around 18% of RBR for full-year 2019. First-quarter 2019 adjusted EPS from continuing operations, which includes 100% of the HSS operations, was $0.18, up $0.15 compared to the prior-year period. Our strong operating performance coupled with higher net interest income, lower depreciation and amortization, and lower share count in the current year period drove this favorable improvement.

GAAP EPS from continuing operations attributable to Navigant Consulting, Inc.was $0.12, up $0.16 compared to the first quarter of 2018 driven by operating items just mentioned and net of income attributable to non-controlling interest in our HSS joint venture. All in all, a very good start for our business in 2019. Diving deeper into our segment-level performance on Page 5. Our healthcare segment RBR was up 32% to $119 million for the first-quarter 2019 compared to the respective period in 2018.

This impressive performance is driven in part by a broad recovery across our several healthcare consulting business, which saw a double-digit growth year over year. This recovery is driven by demand and conversion improvements with both payer and provider clients as we gained traction from 2018 MD hires, and from enhancements we made to our internal structure in 2018. These enhancements include new leadership in certain practice areas, better alignment of internal capabilities and resources, and increased prevalence in traction of our thought leadership initiatives. These actions coupled with an environment in which our clients continue to face margin pressures, new competitive threats and uncertainties related to an ever-evolving regulatory and technology landscape create a robust environment for our consulting franchise.

Another bright spot is the contribution and performance of our HSS joint venture, which drove significant growth in the quarter. Our team alongside our joint venture partner, Baptist Health, is driving significant value for the Baptist Health South Florida health system, including strong cash collection and performance against targets. The team has certainly set a high standard for future revenue cycle start-ups and we are well ahead of our best-case start-up scenario. Beyond HSS, our broader managed services portfolio also delivered nice growth in the quarter, driven by better consistency and execution on our larger comprehensive engagements and a solid ramp-up of modular work.

Revenue growth across the segment flowed nicely in the margins, which improved 830 basis points compared to the first quarter of 2018, driven by strong utilization in healthcare consulting and performance in managed services, namely HSS. HSS recognized higher-than-expected performance-based fees in the quarter including just over $1 million related to 2018 performance that could not be recognized until the first quarter of 2019. All in all, just a great start for the healthcare segment providing momentum as we work through the rest of the year. Turning to our energy segment.

Results in the quarter were consistent with what we saw throughout last year with strong client demand from both commercial and government clients helping drive an 8% RBR growth in the first quarter. We are seeing increased opportunities for infrastructure program management, broad strategic reviews and sustainability-related engagements. Margins remain solid and were consistent with prior year when excluding the impact of an all-hands meeting that occurred in the first quarter this year. This segment has really benefited from anticipating market trends, and improved execution and consistency over the last several years, which has helped drive a 10% annualized growth rate since the first quarter of 2016.

We did experience near-term challenges in the first quarter within our Financial Service and Advisory Compliance segment, which was down 18% year over year, more than we had expected. As you know, of our three segments, FSAC business is the one which can fluctuate in performance more dramatically given larger average engagement size, and we certainly felt this in the first quarter. This decrease was driven by a confluence of factors including a faster-than-expected wind-down of a large monitor ship engagement, simultaneous spending curtailment from select clients and start-up delays on certain new engagements. The team is focused on bolstering and converting our pipeline to respond to the challenge.

We have a strong history of pivoting our focus and capabilities to address the emerging areas of need for our clients in this segment. And given the technology investments we have made in anticipation of this client shift, we remain well-positioned and very bullish on the opportunities set within this industry over the medium and long term. From a business mix perspective, our managed services businesses, which were formerly called Technology, Data & Processes businesses, represented over 30% of our RBR in the first quarter, up 11 percentage points compared to the prior-year period driven by improved operating execution in our healthcare managed services, the contribution of HSS and a new FSAC managed services engagement. The first quarter of 2019 operating profit margins for these businesses were the highest we have seen since 2015 even when excluding the previously mentioned 2018 HSS performance fees that were recognized in the quarter.

Turning to Slide 6, and looking at our liquidity position. Our first-quarter cash balance decreased by approximately $100 million to close the quarter at $107 million of cash on the balance sheet. This decrease was driven by over $55 million of cash returned to shareholders through our share repurchase program and our quarterly dividend, as well as, 2018 bonus payments that were distributed in March. Our day sales outstanding, or DSO, remained solid and finished the quarter at 73 days.

We continued to have a strong financial foundation and with our good cash balance and our undrawn credit facility, we continue to fund investments, pursue growth and return capital to shareholders. I will now turn the call back over to Julie for some closing remarks. Thank you.

Julie Howard -- Chairman and Chief Executive Officer

Thank you, Stephen. Before we open the call for Q&A, I just wanted to provide a brief update on some of our key initiatives in 2019 that we outlined at the start of the year. From a firm culture perspective, we continue to focus on aligning our actions to our people's passions, our client missions and to drive impact in our global community. In the first quarter of '19, we furthered our sustainability efforts by announcing our commitment to setting science-based emission reduction targets while also committing to purchasing 100% renewable energy for our offices around the world.

These commitments are not only good for our communities and our world, but they are also of great importance to many of our stakeholders or employees, recruits, clients and you, our shareholders. With this, we expect to roll out more comprehensive reporting materials over the coming months to share our progress toward these and other firmwide goals. We also continue to execute on our organic investment initiatives through 2019, both deepening and broadening our industry skills and also expanding our evolving digital capabilities that we utilize to enhance both internal processes and our client offerings. We define digital quite broadly and our building skills in three areas.

The first, data tech digital consulting; second, data management and analytics; and third, automation process skills. These digital skills and capabilities are leveraged across all three of our segments, allowing us to expand existing client relationships, compete for new business and maintain our reputation of quality and innovation. On top of our organic actions for growth, we've also been evaluating M&A opportunities to accelerate our growth, expand our industry-focused expertise and deepen our technological capabilities. As we've mentioned before, these pursuits must meet three key evaluation criteria including strategic alignment, cultural fit and attractive financial return.

Our full attention is to put our capital work in 2019, but we will continue to maintain a disciplined approach as we bet different investment opportunities. And finally, as mentioned we continue to execute against our enhanced capital allocation program. And as of March 31, we have returned over $150 million to shareholders through share repurchases and dividends since last August in 2018. We are well on our way to achieving our target to return $175 million of capital to our shareholders over a one-year period.

Also of note and in furtherance of our balanced capital allocation strategy, the board refreshed our share repurchase authorization up to $175 million through the end of 2021, providing us with additional flexibility to continue returning capital to shareholders in a prudent, but balanced way. Just to wrap up, we again are very pleased with the start of the year. As you all know, one quarter does not a year make, but given the overall demand environment and the need for our unique domain expertise and thought leadership, we feel really confident we will deliver on our promises to shareholders in 2019 and beyond. And with that, we'll open the call for Q&A.

Questions and Answers:

Operator

[Operator instructions] Our first question is from Tobey Sommer of SunTrust. Please go ahead.

Julie Howard -- Chairman and Chief Executive Officer

Good morning, Tobey.

Tobey Sommer -- SunTrust Robinson Humphrey -- Analyst

Good morning. Within the healthcare business, is -- was the preponderance of the acceleration at the top line, the result of the JV as you talked about? Were there new wins in there or other kind of ramping business that contributed?

Julie Howard -- Chairman and Chief Executive Officer

It's the combination, Tobey, of improvement in our consulting -- provider-payer consulting businesses as well as the ramp of contribution from the HSS joint venture. So it's a combination of both.

Tobey Sommer -- SunTrust Robinson Humphrey -- Analyst

OK. And what does the pipeline look like for, I guess, both the JV attracting new elements of business as well as the consulting side so far this year?

Julie Howard -- Chairman and Chief Executive Officer

So relative to managed services, we have a pretty reasonable pipeline of opportunities out there that we are considering and pursuing with other, probably like-sized health systems, similar to Baptist Health within the region where the JV operates. We have an opportunity that we're considering within that region, that would be a referral. And so as you know, we've talked about these are long-term sales pursuits, but we're always uniquely positioned because of our revenue cycle consulting expertise that we've applied in a lot of these health systems. So we have opportunities out there that we're in pursuit of.

On the consulting side, we couldn't be more happy and excited to see the turn, if you will, that we had expected in the fourth quarter of '18. We've seen assessments turn into implementations, the conversion rate has increased, the opportunity for more significant strategic advisory and operational improvement opportunities has improved and solidified for us, and we've also seen strong growth in our value transformation capabilities and activities. So a combination of many, many contributors.

Stephen Lieberman -- Chief Financial Officer

Yeah. I would just add, this is Stephen. It goes beyond when you think about managed services beyond HSS, we're seeing some good results from our rest of our managed services team, and with additional contracts and module work and more -- characterizes more medium-sized comprehensive revenue cycle management engagements as well. So it was a very good quarter and the team continues to perform extremely well across our full-managed services group.

Tobey Sommer -- SunTrust Robinson Humphrey -- Analyst

Thank you. I'll just ask two questions then I get back in the queue, two more. Could you comment on why the financial services clients maybe spending less on consulting? And then just a tactical thing here, what's the expected timing of the end of the ankura services agreement?

Julie Howard -- Chairman and Chief Executive Officer

So I will address the first piece. And as we mentioned, it was kind of a confluence of, No. 1, a very large monitorship that we discussed would be winding down this year, and it wound down a little bit more accelerated than we expected in the first quarter. And then second is what we would call kind of a curtailment in spending in levels of some of our larger clients.

And we, we think about that as perhaps them being somewhat cautious and preparing themselves for different economic climates, if you will. They're still spending, we're still focused on regulatory and compliance services, but have also transitioned to more operational improvement support, and support for technology optimization. So we anticipate over the near term that we'll probably continue to see this environment, and we've built that into our plans for the year, but we also can gain a lot of confidence. If you look at our financial services business over the last five years, it has grown significantly all organically year over year over year, but it has volatility and that's because we have our largest client risk in this segment.

So you'll see it go up and down, but in general, the trendline over time has been really strong organic growth. So we're comfortable. And Stephen, you want to talk about the TSA?

Stephen Lieberman -- Chief Financial Officer

Yeah. Thank you. So the TSA is scheduled by our contract to end in August, but that really means September because there's a transition period. So call the TSA running through the September time.

Tobey Sommer -- SunTrust Robinson Humphrey -- Analyst

Thank you.

Operator

Our next question is from Tim McHugh of William Blair & Company. Please go ahead.

Julie Howard -- Chairman and Chief Executive Officer

Good morning, Tim.

Tim McHugh -- William Blair and Company -- Analyst

Good morning. I guess, first, I had to start with one in the weeds. But I want to understand the adjusted EPS figure, I think the $0.18 number seems a little different calculation. Are you at error basically excluding the minority interest associated with the HSS in that version of the presentation? I just want to make sure I'm understanding it right, it looks like that's added back.

Stephen Lieberman -- Chief Financial Officer

Yeah. So the $0.18 is on the same basis where we have presented our guidance. It does include effectively 100% contribution of HSS. So the way that you're kind of doing you're math, yes, it includes the minority interest component in the EPS calculation.

Tim McHugh -- William Blair and Company -- Analyst

OK.

Stephen Lieberman -- Chief Financial Officer

So-- and I would also, and I would also indicate that when we gave our guidance and the way that we're calculating, RBR also includes the full contribution of the HSS joint venture, as well as, our adjusted EBITDA from continuing operations.

Lee Spirer -- Chief Growth and Transformation Officer

As well as the full client.

Stephen Lieberman -- Chief Financial Officer

Yes.

Julie Howard -- Chairman and Chief Executive Officer

Yes. I mean --

Tim McHugh -- William Blair and Company -- Analyst

But then at the EPS line, you're not adjusting out the portion that you don't own of that business is what you're saying?

Stephen Lieberman -- Chief Financial Officer

Well, you need -- if you want to look at that, then you need to look at adjusted EPS for -- attributable to Navigant Inc. from our continuing operations. So I mean, if you want to walk through that, I can kind of show you the numbers. But yes, you would need to effectively back out the minority interest EPS attributable to the joint venture.

Tim McHugh -- William Blair and Company -- Analyst

Right. OK. And when we think about the managed service kind of contribution here, I think there's always some element of performance fees, I guess. So I know you called out $1 million that you couldn't recognize last year.

Is it that kind of the magnitude of above-average performance fees? Or I guess, is it more than that, I guess, I'm trying to understand how much above the normal trendline the revenue and profit from that managed services business you saw this quarter because performance fees were strong?

Stephen Lieberman -- Chief Financial Officer

Yeah. Well, that $1 million was a specific issue just relative to the timing of signing some documentation relative to it. So it was really that $1 million was attributable to kind of work that was done in a prior period, but couldn't recognize because of some contracting. Performance fees, relative to our managed service business, was up this sea -- this quarter because we did perform well under our HSS joint venture against our key performance indicators.

We haven't provided a specific number linked to what the performance fees are on that joint venture. But it's certainly been strong, it was a strong, strong quarter for HSS because of that performance.

Tim McHugh -- William Blair and Company -- Analyst

I guess, what I'm trying to -- is there the potential every quarter for you to earn that magnitude of performance fees or should I think of this as some sort of --

Stephen Lieberman -- Chief Financial Officer

You'd want to -- you for sure want to back out that $1 million we talked about. There's absolutely the potential for us to continue to earn strong performance fees. I will argue that I would say that you can't count on every quarter being as strong as we achieved in the first quarter because it was exceptional results.

Tim McHugh -- William Blair and Company -- Analyst

OK. That's helpful. And then last question. Energy, the headcount, consultant headcount actually was down sequentially by 30 or 40 people, I think it was.

Is that something seasonal about turn over there? Or I guess, what was the nature of that change?

Stephen Lieberman -- Chief Financial Officer

Yes. So we, we did a bit of a reclassification within our presentation. So you've got a few things going on within basically our people that are providing G&A, so our non-billable. We also have what we now created a new category for basically, which is our data analytics team.

So these are individuals that are delivering services, many of them are billable or passed through into the organization. So there's a couple of new categories there.

Julie Howard -- Chairman and Chief Executive Officer

But, but in general, we have a central analytics team, Tim, and then we had resources in our energy segments who were also providing same for clients so we combined, and you'll see that called out, we've combined all of our central analytics expertise into one category. So it's just a shift from consulting to central analytics all client-facing professionals.

Tim McHugh -- William Blair and Company -- Analyst

OK. So just noise in the metrics we're seeing, I appreciate that.

Stephen Lieberman -- Chief Financial Officer

This is noise. This is recategorization.

Lee Spirer -- Chief Growth and Transformation Officer

But logical in terms of bringing together that profession of analytics as they can share best practices across our segments and deliver against our segment needs.

Tim McHugh -- William Blair and Company -- Analyst

Sure. Fair enough. Thank you.

Julie Howard -- Chairman and Chief Executive Officer

Thank you.

Operator

Thank you. Our next question is from Marc Riddick of Sidoti. Please go ahead.

Julie Howard -- Chairman and Chief Executive Officer

Good morning, Mark.

Marc Riddick -- Sidoti and Company -- Analyst

Good morning. How are you?

Julie Howard -- Chairman and Chief Executive Officer

We are doing well.

Marc Riddick -- Sidoti and Company -- Analyst

I wanted to touch a little bit on following up on the actions, the financial customers. I was wondering you touched a little bit on this, I think, it was the last quarter, and I was wondering maybe you could sort of give an update on your thoughts as to delays of activity that may be tied to at the time there's uncertainty around the attorney general's office? I was wondering if you were getting any type of similar feedback now. And if you thought that might have something to do with the cautionary activity of those customers?

Julie Howard -- Chairman and Chief Executive Officer

No. I don't think the two are linked. I think we have kind of a shifting focus for some of our financial institution's clients. They still want to focus on compliance, they need to focus on compliance, but more on a super, better, faster kind of mentality and with operational improvements.

So we've been pivoting toward that. And then separately, I've said that we had some engagements that have just not been able to ramp and part of that was related to the government shutdown and decision-making bodies from the regulatory side, and that has continued. So when we think about financial services, its significant monitorship winding down at the more accelerated fashion. It is some curtailed spending from our financial institution's clients in a regulatory space and then a conversion delay, if you will, on a couple of engagements that we still anticipate will be producing revenue this year.

Marc Riddick -- Sidoti and Company -- Analyst

OK. I was wondering if you could touch a little bit on some of the potential acquisition opportunities that you're seeing out there. And if there's any changes in albeit valuation or attractiveness or some targeted areas that you've seen over the last couple of quarters that might be worth thinking about for us?

Lee Spirer -- Chief Growth and Transformation Officer

Sure. So this is Lee. Let me start. We're continuing to focus in the areas that we've highlighted before that are aligned with our strategic impact.

So it's a pipeline of potential acquisitions that exist around deepening and broadening our industry skills and expanding into adjacencies. There's also a series of potential acquisitions we've been pursuing that are more horizontal capabilities, potentially in data consulting or analytics or digital, that would provide capabilities for each of our segments to benefit from. That pipeline remains very robust. As we've said before, it is a competitive environment, but I don't think that there's any change in the environment from the last time we discussed.

Marc Riddick -- Sidoti and Company -- Analyst

OK. So the valuation gap, if you will, probably is at about similar to where it's been over the last couple of quarters or so?

Lee Spirer -- Chief Growth and Transformation Officer

I believe so.

Julie Howard -- Chairman and Chief Executive Officer

Yes. With higher valuations in some of the technology assets to look at, which would be expected.

Stephen Lieberman -- Chief Financial Officer

And consistent with what it's been.

Marc Riddick -- Sidoti and Company -- Analyst

OK. OK. Great. And then I wasn't sure if you -- forgive me if I missed this if you mentioned it, but did you make any mentions on capex expectations for the remainder of the year? And where some targeted spending areas might be?

Stephen Lieberman -- Chief Financial Officer

Yeah. We think it's going to still be around that $20 million level that we had indicated at the beginning of the year. Capex is largely related to real estate actions and what I characterize is IT spending. So no change from as we're moving along the year.

Marc Riddick -- Sidoti and Company -- Analyst

OK, so I guess, more of it seems to just be more back-half weighted?

Stephen Lieberman -- Chief Financial Officer

Yes.

Marc Riddick -- Sidoti and Company -- Analyst

OK. All right. That's fair. Thank you very much.

Stephen Lieberman -- Chief Financial Officer

Thank you.

Julie Howard -- Chairman and Chief Executive Officer

Thank you. And I guess that's the end of the questions. So we appreciate everybody's interest today, and I'm very excited about our performance and growth and recovery in healthcare and our continued strong performance in energy. And we look forward to sharing more in the second quarter -- after the second quarter.

Thanks all.

Operator

[Operator signoff]

Duration: 33 minutes

Call Participants:

Kyle Bland -- Director of Finance and Investor Relations

Julie Howard -- Chairman and Chief Executive Officer

Stephen Lieberman -- Chief Financial Officer

Tobey Sommer -- SunTrust Robinson Humphrey -- Analyst

Tim McHugh -- William Blair and Company -- Analyst

Lee Spirer -- Chief Growth and Transformation Officer

Marc Riddick -- Sidoti and Company -- Analyst

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