IHF vs XHS: Grades, Fees and Holdings Compared

iShares U.S. Healthcare Providers ETF

IHFBNYSE Arca

State Street SPDR S&P Health Care Services ETF

XHSANYSE Arca

Overlap

38.2%by weight

Expense ratio

XHS −0.02pt a year

IHF0.37%XHS0.35%

Avg volume · 30D

IHF 18.9×the volume

IHF604KXHS31.9K

10Y return · a year

XHS +0.5pt

IHF+11.0%XHS+11.5%

IHF vs XHS Performance

Oct 29, 2021 – Oct 30, 2026

+12.1%IHF+36.6%XHS

Expense ratio: IHF 0.37%; XHS 0.35%, better
Fund size: IHF $1.47B; XHS $234M
1Y total return: IHF +25.1%; XHS +39.7%, better
Yield (12M): IHF 0.91%, better; XHS 0.15%
Holdings: IHF 64; XHS 63
Avg volume (30D): IHF 604K sh, better; XHS 31.9K sh
NAV per share: IHF $59.89; XHS $144.25
52W range

ETF.net Grade

Pillar letters and Scores for IHF, XHS, with each pillar’s weight
Pillar	IHF	XHS
Cost30% weight	B69	A81Higher
Mission25% weight	Not scored	Not scored
Risk15% weight	D32	A78Higher
Tradability15% weight	A82Higher	C54
Holdings10% weight	F12	A87Higher
Durability5% weight	A77Higher	B64

Rank among Health Care (Broad) funds

How we build Categories ›

Same Category. IHF and XHS are both graded against the same 25 Health Care (Broad) funds, so their Grades compare head to head.

Health Care (Broad)⁠

Category · 25 funds

See all 25 ›

XHS ranks 4th and IHF 11th of 25 funds in the Health Care (Broad) Category.

Rank 1AXLVState Street Health Care Select Sector SPDR ETFScore 85
Rank 2AFHLCFidelity MSCI Health Care Index ETFScore 83
Rank 3AVHTVanguard Health Care ETFScore 77
Rank 4AXHSState Street SPDR S&P Health Care Services ETFScore 74
Rank 5AIYHiShares U.S. Healthcare ETFScore 71
Rank 10BFXHFirst Trust Health Care AlphaDEX FundScore 58
Rank 11BIHFiShares U.S. Healthcare Providers ETFScore 56
Rank 12BIHIiShares U.S. Medical Devices ETFScore 55

Our read on each fund

ETF.net Research

IHFBiShares U.S. Healthcare Providers ETF

XHSAState Street SPDR S&P Health Care Services ETF

In short

IHF Healthcare without the drug labs. IHF tracks a US health care providers index, the insurers, hospitals and care networks that deliver and pay for care rather than invent the medicine, and it has been doing that job since 2006.

XHS Most health care ETFs are pharma funds in disguise. XHS buys the delivery system instead: insurers, hospitals, distributors and clinics, roughly equal weighted so one giant insurer does not run the show.

Stated mandate

IHF The Fund seeks to track the investment results of an index made up of U.S. equities in the healthcare providers sector. Its stated strategy is to track the Dow Jones U.S. Select Health Care Providers Index before fund fees and expenses.

XHS The fund seeks to track the total return of the S&P Health Care Services Select Industry Index before fees and expenses, providing targeted exposure to health care services companies.

Why people hold it

IHF Owns the delivery-and-payment side of healthcare, not the drug pipeline. That is a genuinely different slice than a whole-sector fund, run off one index since 2006.
Costs 0.37% a year, under the 0.50% median for health care sector ETFs.
A multi-billion-dollar iShares fund with moderate volume: a real market on both sides of the trade.
Lands in the upper half of the broad health care ETFs we grade, a solid showing for such a targeted mandate.

XHS No drugmakers, no device makers. The index tracks four slices of care delivery: distributors, facilities, health care services and managed care.ssga.com
Modified equal weighting spreads about 60 names across large, mid and small caps, so the portfolio is not a bet on two or three mega caps.ssga.com
0.35% a year sits below the 0.50% median for broad health care ETFs, on a fund that has been running since 2011.
Ranks in the top quartile of the broad health care ETFs we grade.

Worth knowing

IHF About 60 stocks inside one corner of one sector. A narrow lineup like this can swing harder than a diversified healthcare fund.
Broad healthcare rivals are far cheaper (VHT at 0.09%, XLV and FHLC at 0.08%). The focused mandate is what the extra fee buys.
Distributions land quarterly. This is a growth-oriented equity slice, so income is a byproduct rather than the design.

XHS Cheap against the median, not against the giants: XLV, VHT and FHLC charge under a tenth of a percent for cap weighted whole sector exposure.
Thinly traded next to the big sector funds, so spreads and limit orders matter more here.
Leaving out pharma and biotech means it moves differently from a whole sector fund, and insurers and hospitals sit close to reimbursement policy.ssga.com

Full IHF profile⁠

Full XHS profile⁠

IHF vs XHS Holdings

How IHF and XHS differ

Overlap by weight

38.2%

Shared holdings make up 92.7% of IHF and 85.2% of XHS.

Level by level

Sector6 Sectors0.0%
Holdings51 in both38.2%
Asset classEquity100%
Countryby domicile100%

Sector

Sector weights in IHF and XHS, widest gap first
Sector	More in IHFMore in XHS	IHF	XHS
Health Care	XHS +98.1 points	0.0%	98.1%
Managed Health Care	IHF +43.1 points	43.1%	0.0%
Health Care Services	IHF +35.9 points	35.9%	0.0%
Health Care Facilities	IHF +13.6 points	13.6%	0.0%
Health Care Technology	IHF +7.5 points	7.5%	0.0%
Financials	XHS +1.9 points	0.0%	1.9%

Country, concentration and asset class

Country by domicile

Country weights in IHF and XHS, widest gap first
Country	More in IHFMore in XHS	IHF	XHS
United States	Same weight	100.0%	100.0%

Concentration

Weight in the 10 largest Holdings

IHF73.3%
XHS20.7%

Securities held

IHF61
XHS61

Asset class

IHF: Equity
XHS: Equity

Holdings

Only in IHF10
In both51
Only in XHS10

Only in IHF

10 securities, 7.3% of IHF by weight

Veeva Systems Class A5.12%
Doximity Class A0.51%
Heartflow Inc0.49%
Waystar Holding0.42%
Schrodinger Inc0.19%
Teladoc Health Inc0.19%
Certara0.15%
Healthstream0.10%
Phreesia0.08%
Evolent Health Class A0.06%

Only in XHS

10 securities, 14.8% of XHS by weight

Mckesson Corp1.81%
Nutex Health Inc1.75%
Cardinal Health Inc1.72%
Cencora Inc1.68%
Henry Schein Inc1.62%
Guardian Phrmcy Services A1.53%
Sonida Senior Living Inc1.42%
Adapthealth Corp1.32%
Starling Oncology Inc1.18%
Strata Critical Medical Inc0.72%

Weight gaps

All 51 Holdings in both funds, largest gap first.

Holding weights in IHF and XHS, widest gap first
Holding	More in IHFMore in XHS	IHF	XHS
UnitedHealth GroupUNH	IHF +20.35 points	22.07%	1.72%
Cvs HealthCVS	IHF +10.27 points	11.83%	1.56%
Elevance Health IncELV	IHF +7.57 points	9.32%	1.75%
Hca HealthcareHCA	IHF +2.92 points	4.78%	1.86%
CignaCI	IHF +2.81 points	4.57%	1.76%
HumanaHUM	IHF +2.71 points	4.42%	1.71%
Surgery PartnersSGRY	XHS +2.49 points	0.22%	2.71%
Centene CorpCNC	IHF +2.39 points	4.15%	1.76%
Amn HealthcareAMN	XHS +2.03 points	0.22%	2.25%
Labcorp HoldingsLH	IHF +1.71 points	3.60%	1.89%
Us Physical Therapy IncUSPH	XHS +1.67 points	0.16%	1.83%
Quest Diagnostics IncDGX	IHF +1.64 points	3.41%	1.77%
Option Care Health IncOPCH	XHS +1.63 points	0.59%	2.22%
CorvelCRVL	XHS +1.62 points	0.31%	1.93%
Billiontoone Class ABLLN	XHS +1.59 points	0.31%	1.90%
Pacs GroupPACS	XHS +1.55 points	0.28%	1.83%
Clover Health Investments Class ACLOV	XHS +1.50 points	0.24%	1.74%
Pediatrix Medical Group IncMD	XHS +1.48 points	0.29%	1.77%
ProgynyPGNY	XHS +1.45 points	0.27%	1.72%
Privia Health Group IncPRVA	XHS +1.43 points	0.34%	1.77%
Addus Homecare CorpADUS	XHS +1.44 points	0.28%	1.72%
Concentra Group Holdings Parent InCON	XHS +1.39 points	0.59%	1.98%
Astrana HealthASTH	XHS +1.39 points	0.19%	1.58%
NeogenomicsNEO	XHS +1.40 points	0.27%	1.67%
Agilon HealthAGL	XHS +1.38 points	0.13%	1.51%
Omada HealthOMDA	XHS +1.38 points	0.12%	1.50%
Acadia Healthcare CompanyACHC	XHS +1.38 points	0.34%	1.72%
Aveanna Healthcare Holdings IncAVAH	XHS +1.37 points	0.19%	1.56%
Lifestance Health GroupLFST	XHS +1.34 points	0.44%	1.78%
Castle BiosciencesCSTL	XHS +1.28 points	0.14%	1.42%
Hinge Health Class AHNGE	XHS +1.28 points	0.83%	2.11%
National Healthcare CorpNHC	XHS +1.22 points	0.32%	1.54%
Pennant GroupPNTG	XHS +1.21 points	0.18%	1.39%
Genedx Holdings Class AWGS	XHS +1.16 points	0.19%	1.35%
Brookdale Senior Living IncBKD	XHS +1.09 points	0.30%	1.39%
Guardant HealthGH	IHF +1.07 points	2.94%	1.87%
RadnetRDNT	XHS +1.07 points	0.64%	1.71%
Tenet Healthcare CorpTHC	IHF +1.05 points	2.70%	1.65%
Hims Hers Health Class AHIMS	XHS +1.03 points	0.72%	1.75%
Davita IncDVA	XHS +0.96 points	0.78%	1.74%
ChemedCHE	XHS +0.86 points	0.86%	1.72%
Alignment HealthcareALHC	XHS +0.85 points	0.17%	1.02%
HealthequityHQY	XHS +0.75 points	1.05%	1.80%
Fulgent GeneticsFLGT	XHS +0.71 points	0.04%	0.75%
Universal Health Services Class BUHS	XHS +0.53 points	1.12%	1.65%
Ensign GroupENSG	XHS +0.49 points	1.29%	1.78%
Opko HealthOPK	XHS +0.45 points	0.09%	0.54%
Community Health Systems IncCYH	XHS +0.40 points	0.03%	0.43%
Molina Healthcare IncMOH	XHS +0.38 points	1.31%	1.69%
Brightspring Health Services IncBTSG	XHS +0.20 points	1.40%	1.60%
Encompass HealthEHC	XHS +0.13 points	1.65%	1.78%

All 61 IHF holdings⁠All 61 XHS holdings⁠

How we measure overlap

Each holding counts at its smaller weight in the two funds, summed over the full Holdings. Sector, country and asset class use the same rule on each fund’s split. Cash, FX and derivative lines stay out of the counts. Two bond funds get no overlap figure.

IHF vs XHS Cost

Overpaying IHF vs XHS

$387

On $10,000 over 30 years. 7% growth a year before fees, expense ratio only.

IHF 0.37%
$7,513
XHS 0.35%
$7,126

Amount$10,000

Years30 years

Cost over time

IHF 0.37%
XHS 0.35%
Overpaying

Year by year

Year	IHF	XHS	Overpaying
10	$670	$634	$36
20	$2,590	$2,454	$136
30	$7,513	$7,126	$387

Expense ratio

0.37%IHF
0.35%XHS, cheaper

XHS0.35%IHF0.37%

0.08%0.85%

Middle half of Health Care (Broad) funds
Median 0.50%

XHS 5th cheapest of 25 funds

IHF 7th cheapest of 25 funds

IHF vs XHS Dividends

Last 12 months to Oct 30, 2026

Yield (12M): IHF 0.91%, better; XHS 0.15%
Payout (12M): IHF $0.54; XHS $0.21
Last payment: IHF $0.13; XHS $0.01
Ex-dividend: IHF Sep 15, 2026; XHS Sep 21, 2026
Paid on: IHF Sep 18, 2026; XHS Sep 23, 2026
Frequency: IHF Quarterly; XHS Quarterly

Distribution history

Per share, 2017 to 2026, same scale for both

IHFQuarterly · 40 paymentsAll IHF payments⁠

XHSQuarterly · 39 paymentsAll XHS payments⁠

IHF vs XHS Risk

Fall from peak · 5 years

Risk facts

VolatilityStd dev, 3 years: IHF 23.0%XHS 20.8%, better
Return per unit of riskSharpe ratio, 3 years: IHF 0.23XHS 0.85, better
Worst fallMax drawdown, 5 years: IHF −29.8%, betterXHS −30.0%
Market sensitivityBeta, 5 years: IHF 0.85XHS 0.93; Market = 1

IHF and XHS in the news

All news⁠

Deep Dive
Health care's 1.8% week was four large caps, not a biotech rally
Sep 19, 2026IHFXHS
Deep Dive
Health care ETFs spent 2026 between a 28% biotech rally and a 16% device slide
Sep 14, 2026IHFXHS
Top Movers
T-Mobile falls 13.3% and tower stocks rise on the SpaceX spectrum deal
Oct 9, 2026IHF

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IHF vs XHS

In short

Stated mandate

Why people hold it

Worth knowing

How IHF and XHS differ

Level by level

Sector

Country, concentration and asset class

Country by domicile

Concentration

Asset class

Holdings

Only in IHF

Only in XHS

Weight gaps

Cost over time

Year by year

Distribution history

Fall from peak · 5 years

Risk facts

Health care's 1.8% week was four large caps, not a biotech rally

Health care ETFs spent 2026 between a 28% biotech rally and a 16% device slide

T-Mobile falls 13.3% and tower stocks rise on the SpaceX spectrum deal

How IHF and XHS differ

Level by level

Sector

Country, concentration and asset class

Country by domicile

Concentration

Asset class

Holdings

Only in IHF

Only in XHS

Weight gaps