XHSvsFXHETF Comparison
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State Street SPDR S&P Health Care Services ETF (XHS) and First Trust Health Care AlphaDEX Fund ETF (FXH) belong to the same industry segment: US Health Care. Both ETFs have the same top 3 sector exposures: and Health Care. XHS is less expensive with a Total Expense Ratio (TER) of 0.35%, versus 0.61% for FXH. XHS is up 3.51% year-to-date (YTD) with +$12M in YTD flows. FXH performs worse with -0.66% YTD performance, and -$56M in YTD flows. Run a side-by-side ETF comparison of XHS and FXH below, and assess how they stack up in performance, liquidity, risk, exposure, holdings, and more, helping you select the best ETF for your investments.
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XHS vs FXH performance and flow charts
Performance
Cumulative Flows
Historic performance and flows
Data as of 05/01/2026
| 1M | 3M | YTD | 1Y | 3Y | 5Y | ||
|---|---|---|---|---|---|---|---|
| Perf. | XHS FXH | +10.01%+7.11% | +2.65%-1.29% | +3.51%-0.66% | +16.22%+12.90% | +24.01%+4.37% | +0.86%+0.28% |
| Flows | XHS FXH | +$7M+$354K | -$1M-$62M | +$12M-$56M | -$1M-$118M | -$27M-$708M | -$31M-$500M |
Volatility and drawdown
| 3M | 1Y | 3Y | 5Y | ||
|---|---|---|---|---|---|
| Volatility | XHS FXH | +16.72%+17.16% | +17.87%+16.20% | +18.06%+15.23% | +21.14%+16.68% |
| Max drawdown | XHS FXH | -9.92%-9.86% | -12.54%-12.07% | -17.78%-17.89% | -32.53%-29.40% |
| Max drawdown duration | XHS FXH | 53d60d | 128d113d | 362d331d | 1768d1697d |
Trading data
XHS | FXH | |
Last sale 5/1/2026 at 1:30 PM | $110.53 | $112.45 |
| Previous close 04/29/2026 | $109.90 | $112.93 |
| Consolidated volume 04/29/2026 | ||
| Average volume 30 days | ||
| Average discount or premium 30 days | ||
| Average Bid/Ask spread 30 days |
Replication quality
Data as of April 30, 2026
1-year trailing difference
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XHS | FXH | |
|---|---|---|
| Tracking error | ||
| Tracking difference | ||
| 1 year cumulative return difference | ||
| Best | ||
| Worst | ||
| Daily return difference | ||
| Average | ||
| Worst | ||
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Main metrics
Last update 5/1/2026 at 1:30 PM
Live
Closed
XHS | FXH | |
|---|---|---|
| Last price | $110.53 | $112.45 |
| 1D performance | +0.57% | -0.43% |
| AuM | $98.43 M | $874.19 M |
| E/R | 0.35% | 0.61% |
Characteristics
XHS | FXH | |
|---|---|---|
| Management strategy | Passive | Passive |
| Provider | State Street Investment Management | First Trust |
| Benchmark | S&P Health Care Services Select Industry Index | StrataQuant Health Care Index |
| N° of holdings | 51 | 71 |
| Asset class | Equities | Equities |
| Trailing 12m distribution yield | Join | Join |
| Inception date | September 28, 2011 | May 8, 2007 |
| ESG | No | No |
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Exposure
Countries
XHS
USA
99.89%
Other
0.11%
FXH
USA
95.47%
Other
4.53%
Sectors
XHS
Health Care
86.56%
Other
13.44%
FXH
Health Care
93.76%
Other
6.24%
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Diversification
XHS
Total weight of top 15 holdings out of 15
30.62%
FXH
Total weight of top 15 holdings out of 15
35.37%
Top 15 holdings
Data as of March 31, 2026
XHS
MEDNAX
2.18%
HEALTHEQUITY I/D
2.15%
GUARDANT HEALTH INC
2.12%
CORVEL
2.08%
US10950A1060
2.08%
CIGNA
2.06%
HUMANA
2.05%
ELEVANCE HEALTH INC
2.04%
DAVITA INC
2.00%
US5049221055
1.99%
ACADIA HEALTHCARE COMPANY
1.98%
CARDINAL HEALTH
1.98%
ALIGNMENT HEALTHCARE
1.98%
QUEST DIAGNOSTICS
1.97%
PROGYNY INC
1.96%
FXH
ACADIA HEALTHCARE COMPANY
3.83%
APELLIS PHARMACEUTICALS
2.95%
PFIZER
2.63%
BIOGEN INC
2.40%
CARDINAL HEALTH
2.37%
HCA HEALTHCARE
2.33%
INCYTE
2.19%
IONIS PHARMACEUTICALS INC
2.18%
INSMED
2.17%
UTD THERAPEUT
2.15%
MERCK & CO INC
2.11%
NATERA
2.04%
LILLY
2.04%
MEDPACE HOLDINGS INC
2.00%
AMGEN-T
1.98%
Frequently asked questions about XHS and FXH
How have the XHS and FXH ETFs performed in 2026?
As of May 1, 2026, XHS is up 3.51% year-to-date (YTD), while FXH has lost -0.66%. That puts XHS better performer ahead so far this year.
Which ETF is attracting more investor money: XHS or FXH?
Year-to-date, the XHS ETF saw +$12M in flows, compared to -$56M for FXH.
Which ETF is more volatile: XHS or FXH?
Over the past year, XHS had a volatility of 17.87%, while FXH experienced 16.2%.
Which ETF is bigger: XHS or FXH?
As of May 1, 2026, XHS holds $98.43 M in assets under management (AUM), while FXH manages $874.19 M.
What sectors do the XHS and FXH ETFs invest in?
XHS leans toward sectors like Health Care. Meanwhile, FXH focuses on Health Care.
What are the top holdings of the XHS ETF and FXH ETF?
XHS top holdings include MEDNAX, HEALTHEQUITY I/D and GUARDANT HEALTH INC. FXH holds in its top three: ACADIA HEALTHCARE COMPANY, APELLIS PHARMACEUTICALS and PFIZER.
Which ETF is more diversified: XHS or FXH?
XHS holds 58 securities with 30.62% of its assets in the top 15. FXH has 75 securities and a top 15 weight of 35.37%.
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