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.
Follow the theme against the wider market.
Series before each basket's creation date are a backtest of the membership as of creation; live tracking starts at creation.
| Return | 1 day | 5 days | 20 days | 60 days | MTD | YTD | 1 year |
|---|---|---|---|---|---|---|---|
| Basket | -0.9% | +2.4% | +11.7% | +2.7% | +11.8% | +37.6% | +32.7% |
| vs S&P 500 | -1.4% | +1.9% | +10.9% | -1.9% | +10.1% | +20.9% | +14.6% |
1y · 2025-10-21 – 2026-10-21 · 252 / 252 sessions
Basket total returns · Annualized using 252 trading sessions · 0% risk-free rate and downside target. As of 2026-10-21 · close.
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 ≈.
Current members and the reasoning behind each inclusion. Returns are for individual holdings.
| Why it’s included | Added | |||||
|---|---|---|---|---|---|---|
| HUMHumana | Medicare Advantage pure-play torque | -0.5% | -0.5% | +13.5% | +67.3% | 2026-06-11 |
| CICigna | Commercial + PBM mix | -0.7% | +5.1% | +13.5% | +12.5% | 2026-06-11 |
| CNCCentene Corporation | Medicaid + exchanges exposure | -0.8% | +0.1% | +13.1% | +70.7% | 2026-06-11 |
| UNHUnitedHealth Group | Scale payer + Optum services | -0.5% | +5.4% | +12.3% | +28.8% | 2026-06-11 |
| ELVElevance Health | Blues franchise scale | -1.4% | +1.4% | +8.9% | +25.7% | 2026-06-11 |
| CVSCVS Health | Aetna + retail health + PBM | -1.4% | +3.4% | +8.8% | +20.5% | 2026-06-11 |
Equal-weighted; monthly rebalance, buy-and-hold between rebalances; dated membership changes reset the target weights.
Tracked since 2026-06-11. Membership decisions are documented below.
Read the methodology →Basket returns include dividends. “vs S&P 500” compares the basket’s compounded growth with the benchmark’s. Green means positive; red means negative.
Cross-checked against IHF. Daily return correlation: 0.93 across 1710 sessions. cap-weighted and UNH-heavy; also holds providers, who sit on the other side of the cost-trend trade
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.
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.
MOH removed — no longer in the S&P 500 universe (flagged by the widening pass’s constituent check).
Initial composition: the payer complex.