Milliman, the actuarial and financial risk management firm, has introduced a pair of exchange-traded funds that seek to mirror the trajectory of healthcare cost inflation in the United States. The funds, which began trading this week, are designed for financial advisors and their clients looking to hedge against persistently rising medical expenses, particularly within health savings accounts, 401(k) plans, and individual retirement accounts.
The Milliman Healthcare Inflation Guard ETF (ticker: MHIG) targets returns that align with the annual increase in healthcare costs for an average individual enrolled in an employer-sponsored health plan. A second vehicle, the Milliman Healthcare Inflation Plus ETF (ticker: MHIP), aims to deliver returns approximately two percentage points above that benchmark. Both funds employ a multi-asset strategy that includes equities concentrated in the healthcare sector, a liquid alternatives bucket primarily allocated to gold, and a fixed-income component dominated by Treasuries.
“What we’re trying to target is something that doesn’t go down that much, which is healthcare cost inflation,” said Adam Schenck, principal and managing director of fund services at Milliman. He noted that the funds have the flexibility to shift among liquid assets as market conditions evolve.
The ETFs are anchored by Milliman’s Health Trend Guidelines, a series of indexes that track the cost, utilization, and unit prices of healthcare services. These benchmarks are widely used by insurers, hospital systems, and employer health plans to project future medical spending. Hans Leida, a principal and consulting actuary at Milliman, said the firm collects data on roughly 35 million insured lives each month, representing about 20% of the commercially insured U.S. population. “We used a lot of that experience to develop this strategy,” Schenck added.
The launch comes amid rapid growth in the HSA market. Assets in health savings accounts reached $159 billion across 40 million accounts by mid-2024, according to Devenir, a 16% year-over-year increase. Investment assets within HSAs rose 30% to $73 billion over the same period, underscoring demand for vehicles that can outpace medical inflation. Separately, the global ETF market has swelled to $19.85 trillion, a $4.9 trillion jump since the end of 2024, per State Street’s 2026 Global ETF Outlook. U.S.-listed ETF assets alone are projected to approach $20 trillion by 2030.
Advisors may consider these funds as a complement to broader portfolios, particularly for clients concerned about the erosion of purchasing power due to healthcare costs. The strategy also aligns with trends in retirement planning, where regulatory shifts are pushing for greater transparency in fee structures and investment outcomes. Meanwhile, the integration of AI-driven research tools is helping advisors analyze complex data sets like Milliman’s health trend indexes more efficiently.
Milliman’s move into ETFs reflects a broader push by traditional consulting firms to package proprietary data into investable products. The firm’s deep bench of actuaries and healthcare analysts gives it a unique vantage point on medical cost trends, which have consistently outpaced general inflation over the past two decades. By offering a direct hedge against those rising costs, the funds could appeal to both institutional and retail investors seeking to preserve long-term purchasing power.
