The medical-cost-trend cycle in one basket: utilization spikes, Medicare Advantage rate pressure, and PBM scrutiny all hit here first. Historically violent repricings in both directions — a sentiment gauge for the whole healthcare payer complex.
Basket total returns · Annualized using 252 trading sessions · 0% risk-free rate and downside target. As of 2026-10-21 · close.
How these statistics are calculated
Risk methodology
Sharpe: average daily simple return divided by its sample standard deviation, multiplied by √252. The risk-free rate is assumed to be 0%; this is not a cash-adjusted ratio.
Sortino: average daily simple return divided by downside deviation, multiplied by √252. Downside deviation is the square root of the average squared shortfall below 0%, counting all sessions, including zeros for gains.
Historical volatility: √(252 × average squared daily log return), matching the Vol page’s realized-volatility convention. This differs from the sample standard deviation used in Sharpe.
Each period requires complete history and at least 5 sessions. MTD and YTD follow the calendar; 1y is 252 sessions. Missing data or an undefined ratio displays — with a reason. Short periods can produce unstable ratios; intraday snapshots include a partial session. History before this basket’s creation is backtested. If a new basket has no stored daily return series yet, estimates from its rounded published chart levels are marked ≈.
Basket returns include dividends. “vs FW 3000” compares the basket’s compounded growth with the benchmark’s. Green means positive; red means negative.
Cross-checked against IHF. Daily return correlation: 0.90 across 1710 sessions. cap-weighted and UNH-heavy; also holds providers, who sit on the other side of the cost-trend trade
Membership history & changes
Membership history
expand
FW 3000 pass: added MOH, OSCR, ALHC — names outside the S&P 500 but inside our broad universe; they count only in the FW 3000 version of this basket. Effective-dated to creation so the broad backtest covers the full set. The S&P 500 basket is unchanged.
review
Widening pass: the remaining six are the complete S&P 500 managed-care complex; providers are deliberately excluded (utilization helps them and hurts insurers — mixing the two would cancel the signal). Reference pinned to IHF with that caveat.
drop
MOH removed — no longer in the S&P 500 universe (flagged by the widening pass’s constituent check).
Business models the market discounts when GLP-1 adoption accelerates: indulgent packaged food and drinks, alcohol, quick-service restaurants, and the medical devices treating obesity comorbidities (sleep apnea, diabetes hardware, dialysis). A monitoring list for underperformance — not a recommendation in either direction.
The other side of the medical-cost-trend trade: the utilization that squeezes managed care is revenue here. Hospitals, surgery centers, behavioral and rehab, dialysis, home-based care, and the reference labs that price volume. Run it against managed-care — divergence between the two baskets IS the cost-trend signal. Policy risk cuts through both: site-neutral payment proposals and ACA subsidy expiry hit providers' payer mix directly.
60% semiconductors through SMH and 40% US energy through XLE. Target weights reset monthly and drift with returns between rebalances. The ETF holdings are the same in both universe views; only the comparison benchmark changes.