+0.4%
since Oct 2
The idea
I believe healthcare is splitting into two systems, and the growing half is people paying directly for blood panels, genomics, telehealth, and longevity care. This basket owns that whole stack: the cash-pay front doors, the diagnostics and genome sequencing behind them, the lab-tools suppliers selling into everyone, and the therapeutics that demand pulls through, with no insurers or hospital chains. It is spread across names on purpose rather than concentrated in one bet, with a small cash buffer, meant to be held for years unless the shift toward cash-pay care stalls out.
What it owns
- Genetic and cancer testing is increasingly something people pay for directly, and these companies run the tests at the core of precision medicine. · NateraIt leads in genetic testing that patients increasingly order themselves, from prenatal screens to cancer monitoring, as genomics becomes a direct-pay service., Guardant HealthIts blood-based cancer tests, including screening that people may pay for out of pocket, bet directly on diagnostics moving to simple blood draws., IlluminaIt makes the sequencers that nearly every genomics test in the stack runs on, so it benefits as sequencing becomes cheaper and testing volume rises., Tempus AIIt turns diagnostic data into AI-driven testing and treatment matching, the layer that makes personalized care practical at scale., GeneDx HoldingsIt sequences genomes to diagnose rare disease, the kind of answer families pursue and pay for when the insurance path does not work.25%
- Telehealth, clinics, and wellness businesses that collect cash directly from patients form the visible entry point to the shift away from insurance-dependent care. · Hims & Hers HealthIt is the clearest cash-pay front door, with subscribers paying monthly out of pocket for telehealth, weight loss, and prescriptions with no insurer in the loop., IDEXX LaboratoriesIt runs diagnostics behind veterinary care, a market that has always been cash-pay and shows what healthcare looks like when people spend directly on testing and visits., Life Time GroupIt offers memberships, recovery, and wellness services that people pay for directly, showing how consumers treat health spending when it is not tied to insurance., LifeMDIt is a telehealth bet on the same cash-pay front door as larger competitors, with exposure to the growth of direct-pay virtual care.18%
- Every lab in the stack buys instruments and reagents from these suppliers, so they benefit regardless of which test provider or front door wins. · Thermo Fisher ScientificIt supplies instruments and reagents to nearly every lab in the stack, so it benefits from rising testing volume across all segments of cash-pay care., DanaherIt makes the diagnostic and bioprocessing tools underneath the testing boom, a way to own the shift without betting on any single front-door winner., Agilent TechnologiesIt supplies the instruments and consumables that labs buy as testing volume grows across the cash-pay diagnostics layer.18%
- Drugs and gene therapies that patients seek out and often pay for directly, like GLP-1s, create the demand pull behind the entire cash-pay healthcare shift. · Eli LillyIt makes the drugs people are most willing to pay cash for, including GLP-1s sold directly to patients outside insurance coverage., Vertex PharmaceuticalsIt shows that personalized therapeutics can build durable value, from rare diseases to newer treatments that patients and health systems pay for because nothing else works., CRISPR TherapeuticsIt is a frontier bet on gene editing as the far end of personalized care that patients and health systems pay for because existing treatments fail.17%
- Routine blood panels are the entry point of cash-pay care, and these labs process them at scale for both traditional and direct-to-consumer paths. · Quest DiagnosticsIt now sells blood panels directly to consumers who skip the doctor and pay out of pocket, forming the backbone of consumer-initiated testing., QiagenIt makes sample-prep kits and molecular tools that sit under blood testing and genomics, paid by everyone running tests regardless of the front-door winner., Labcorp HoldingsIt is the other scale lab backbone, with both direct-to-consumer ordering and traditional lab services, benefiting from rising overall testing volume.14%
- Cash8%