ETF Research Center

SPDR S&P Health Care Services ETF is an exchange-traded fund incorporated in the USA. The Fund's objective is to replicate as closely as possible the performance of the S&P Health Care Services Select Industry Index.

FUND BASICS
Category	US Equities
Fund Sponsor	SSGA Funds Management Inc
Website	www.spdrs.com
Inception date	Sep 29, 2011
Assets (mns)	$104
Currency	USD
Expense ratio	35 bp
Distributions	Quarterly

FUND STRUCTURE
Regulation	Open-Ended Fund
Custodian	State Street Bank & Trust
Weighting	Equal
Index replication	n/a
Uses derivatives	No
Options available	No

SECTOR BREAKDOWN

CONSTITUENT BREAKDOWN
No. of constituents	49
Wgt avg mkt cap (mns)	$18,241
Large cap (>$10bn)	36.3%
Mid cap ($2-10bn)	35.2%
Small cap (<$2bn)	28.5%
Developed mkts	100.0%
Emerging mkts	0.0%

TOP TEN HOLDINGS
Total	26.4 %
AMN HEALTHCARE SERVICES INC	2.9 %
AMEDISYS INC	2.7 %
LHC GROUP INC	2.7 %
MCKESSON CORP	2.7 %
DAVITA INC	2.6 %
ENCOMPASS HEALTH CORPORATION	2.6 %
LABORATORY CRP OF AMER HLDGS	2.6 %
CIGNA CORP	2.6 %
ADDUS HOMECARE CORP	2.5 %
CENTENE CORP	2.5 %

TOP COUNTRY EXPOSURE
	UNITED STATES	98.2 %
	PUERTO RICO	0.9 %

HISTORICAL PERFORMANCE info

	Custom date range	Compare to
	thru

Standardized Annual Returns (thru January 31)
Year-to-date	1 year	5 years	10 years	Since Incep.
-0.9%	6.0%	-7.5%	--	5.8%

Market Correlations
versus...	Beta	R-squared
S&P500	1.19	57%
MSCI EAFE	0.94	30%
MSCI Emg. Mkts.	0.59	20%

Technical Indicators
Recent close	$77.45
30d moving avg.	$75.33
Annualized volatility	19.1%
Short interest (ETF)	0.4%
Short interest (Underlying)	6.6%
Relative strength (RSI)	65

Liquidity measures
Avg. volume (thou.)	5
Turnover	0.4%
Bid/Ask (% of price)	0.18%
ADV underlying (mns)	$4,635

Distributions

FINDING ALTERNATIVE FUNDS

Below is a list of 19 potential alternatives to the SPDR S&P Health Care Services ETF ETF based on the alternatives' overlap in portfolio holdings with XHS. Consider funds with lower expense ratios and/or higher ALTAR Score™ ratings as possible alternatives.

Benchmark ticker:

XHS

Expense:

35 bp

ALTAR Score™:

5.4%

ALTERNATIVE ETFs BASED ON OVERLAP WITH XHS
Ticker	Fund Name	Overlap¹ vs XHS (%)	Expense ratio (bp)	Savings vs XHS (bp)	ALTAR Score™ (%)	ALTAR vs XHS (%)
IHF	iShares US Healthcare Providers	43.1	43	-8	7.1	+1.7
FXH	First Trust Health Care Alphadex	26.5	62	-27	5.3	-0.1
RYH	Invesco S&P Equal Weight Healthcare	25.8	40	-5	6.6	+1.2
JHMH	John Hancock Multifactor Health Care	22.3	40	-5	6.2	+0.9
IEHS	iShares Evolved U.S. Healthcare Staples	22.2	18	17	5.6	+0.2
PSCH	Invesco S&P Small Cap Health Care	21.9	29	6	3.2	-2.2
FHLC	Fidelity MSCI Health Care	15.3	8	27	5.6	+0.3
XLV	Health Care Select Sector SPDR	15.1	13	22	7.0	+1.6
VHT	Vanguard Health Care	15.0	10	25	5.5	+0.2
IYH	iShares US Healthcare	14.7	43	-8	6.1	+0.7
RWL	Invesco S&P 500 Revenue ETF	12.7	39	-4	7.2	+1.8
FLAG	Forensic Accounting	11.3	152	-117	8.2	+2.8
IXJ	iShares S&P Global Healthcare	11.1	46	-11	6.1	+0.7
ESGL	Invesco ESG Revenue ETF	10.8	40	-5	8.4	+3.0
OLD	Long-Term Care	10.6	35	0	4.3	-1.1
PTH	Invesco DWA Healthcare Momentum	10.0	60	-25	-3.2	-8.5
SPVU	Invesco S&P 500 Value	8.5	13	22	10.5	+5.2
VUSE	Vident Core US Equity	8.0	48	-13	7.6	+2.2
ROGS	Lattice Global Small Cap Strategy	8.0	34	1	7.5	+2.1

¹Overlap is the percentage of holdings by weight that are identical. For example, if Fund A has a 2% position in Apple, Inc. (AAPL) and Fund B has a 5% position, their overlapping position in AAPL is 2%.

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RESULTS & ESTIMATES

	2015	2016	2017	2018	2019	2020E	2021E
Sales per share	**	**	**	**	**	**	**
Earnings per share	**	**	**	**	**	**	**
Dividends per share	**	**	**	**	**	**	**
Book value per share	**	**	**	**	**	**	**

Sales per share growth		**%	**%	**%	**%	**%	**%
EPS growth		**%	**%	**%	**%	**%	**%

Sales per share growth		**%	**%	**%	**%	**%	**%
EPS growth		**%	**%	**%	**%	**%	**%

OTHER FUNDAMENTAL METRICS

Long term EPS growth est.	**%		Debt-to-equity	**x
Asset turnover	**%		Assets-to-equity	**x

Return on equity

Revision activity*

*Six months ago = 100

Net margins

Compound annual growth rates

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VALUATION METRICS

	2019	2020E	2021E
Price-to-sales	**	**	**
Price-to-earnings	**	**	**
Price-to-cash flow	**	**	**
Price-to-growth	**	**	**
Price-to-book value	**	**	**
Yield	**	**	**

Historical valuation trends

Forward multiple:	SPDR S&P Health Care Services ETF
Relative to:	S&P500	MSCI EAFE	MSCI Emg. Mkts.	Other ETF:

NEUTRAL

Average appreciation potential. A rating of NEUTRAL is assigned to ETFs with ALTAR Scores in the middle quintile (ranking between 40%-60%) of their category. This indicates that valuations adequately reflect the fundamentals of stocks in these funds.

ALTAR Score™

Calculation of ALTAR Score™
Avg. Return on Equity	12.0	%
Divided by: Fwd. P/BV	2.1	x
Less: Expense ratio	35	bp
Equals: ALTAR Score	5.4	%

More information on ALTAR Score™

MODERN PORTFOLIO THEORY info

CONSENSUS RECOMMENDATIONS: FUND CONSTITUENTS

COMPOSITE RATING	1.45	CATEGORY AVERAGE	1.56

The composite rating is a weighted average of analysts' consensus recommendations for individual ETF constituents, based on the following scale: BUY = 1; OVERWEIGHT = 1.5, HOLD = 2; UNDERWEIGHT = 2.5; and SELL = 3. Readers are cautioned that because analyst ratings tend to be inflated, the composite score may be more useful as a relative measure of sentiment between funds rather than as a stand-alone recommendation.