Select Medical Holdings Corporation SEM reported first-quarter 2018 earnings of 29 cents per share, which outperformed the Zacks Consensus Estimate by 7.4%. Also, the bottom line improved 38.1% year over year.Select Medical Holdings Corporation Price, Consensus and EPS Surprise Select Medical Holdings Corporation Price, Consensus and EPS Surprise | Select Medical Holdings Corporation Quote The company’s first-quarter results benefited from a solid performance across all its segments along with higher revenues.Operational UpdateOperating revenues of Select Medical grossed $1.3 billion during the quarter under review, up 14.8% year over year. Higher segmental revenues led to this upside. Moreover, the top line beat the Zacks Consensus Estimate by 0.7%.Total operating expenses amounted to $1.1 billion, up 14.5% year over year. Increase of 14.7% in cost of services, 9.9% higher depreciation and amortization expenses and a 13.2% rise in general and administrative expenses induced this overall escalation in expenses.Income from operations improved 18.3% year over year to $108.6 million on the back of stronger revenues.Adjusted EBITDA grew 17.5% year over year to $163.2 million.Segment UpdateLong Term Acute Care segment operating revenues rose 4.4% year over year to $464.7 million.Adjusted EBITDA was $73 million, having inched up 0.9% year over year with margins contracting 60 basis points (bps) to 15.7%.Inpatient Rehabilitation segment operating revenues increased 20.7% year over year to $174.8 million.Adjusted EBITDA was $26.8 million, soaring 64% year over year with margins having improved 400 basis points (bps) to 15.3%.Operating revenues from Outpatient Rehabilitation rose 2.8% year over year to $257.4 million.Adjusted EBITDA was $30.5 million, having slid 2.9% year over year with margins contracting 60 basis points (bps) to 11.9%.Concentra segment reported net operating revenues of $356.1 million, up 42.1% from the prior-year quarter. Adjusted EBITDA increased 35.7% year over year to $57.8 million.Adjusted EBITDA margin contracted 80 bps to 16.2%.Financial UpdateSelect Medical exited the first quarter with cash of $119.7 million, down 2.3% from $122.5 million at year-end 2017.As of Mar 31, 2018, long-term debt, net of current portion, increased 29.9% to $3.5 billion from the figure recorded at 2017-end.Cash flow from operations was $50.7 million for the three months ended Mar 31, 2018, which compared favorably with ($55.9) million for the same period in 2017.2018 GuidanceSelect Medical expects earnings per share between 97 cents and $1.12. Net income is anticipated between 93 cents and $1.08 (which includes the first-quarter loss on early retirement of debt and U.S. HealthWorks acquisition costs and the related tax effects).Net operating revenues are projected between $5 billion and $5.2 billion.Adjusted EBITDA is likely to be between $630 million and $660 million.Zacks RankSelect Medical carries a Zacks Rank #3 (Hold). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.Performance of Other Health Maintenance OrganizationsAmong other players from the industry having reported first-quarter earnings so far, the bottom line of Anthem, Inc. ANTM, Centene Corporation CNC and UnitedHealth Group Incorporated UNH beat the respective Zacks Consensus Estimate.Looking for Stocks with Skyrocketing Upside?Zacks has just released a Special Report on the booming investment opportunities of legal marijuana.Ignited by new referendums and legislation, this industry is expected to blast from an already robust $6.7 billion to $20.2 billion in 2021. Early investors stand to make a killing, but you have to be ready to act and know just where to look.https://finance.yahoo.com/news/select-medical-holdings-corpo...See the pot trades we're targeting>>Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report UnitedHealth Group Incorporated (UNH): Free Stock Analysis Report Select Medical Holdings Corporation (SEM): Free Stock Analysis Report Anthem, Inc. (ANTM): Free Stock Analysis Report Centene Corporation (CNC): Free Stock Analysis Report To read this article on Zacks.com click here. Zacks Investment Research