Here's Why One Fund Invested $38 Million in an International Stock ETF

Adventist Health System West reported a new position in IXUS valued at approximately $38.2 million as of September 30, according to an SEC Form 13F filed on Tuesday.

What Happened

According to a Securities and Exchange Commission (SEC) filing released Tuesday, Adventist Health System West established a new position in the iShares Core MSCI Total International Stock ETF (NASDAQ:IXUS). The fund acquired approximately 462,368 shares for a total transaction value of $38.2 million during the third quarter.

What Else to Know

This new position in IXUS represents 6.2% of Adventist Health System West's reportable 13F assets under management as of September 30.

Top holdings after the filing:

• NYSEMKT:VOO: $300.4 million (48.9% of AUM)
• NYSEMKT:VEA: $67.8 million (11% of AUM)
• NYSEMKT:ITOT: $67.1 million (10.9% of AUM)
• NASDAQ:VONV: $61.9 million (10.1% of AUM)
• NASDAQ:VTIP: $38.8 million (6.3% of AUM)

As of Thursday, shares were priced at $83.98, with a one-year change of 20% versus a 16% gain for the S&P 500.

ETF Overview

ETF Snapshot

• IXUS's investment strategy seeks to track the MSCI ACWI ex USA IMI Index, providing broad exposure to developed and emerging markets equities outside the United States.
• The fund is structured as a passively managed ETF designed for long-term international equity allocation.
• It serves as a core holding for diversified international portfolios due to its large asset base and broad market coverage.

The iShares Core MSCI Total International Stock ETF (IXUS) offers investors comprehensive access to global equity markets outside the United States, combining both developed and emerging market exposures in a single fund. With its large asset base, it serves as a core holding for diversified international portfolios. The fund's broad market coverage and transparent indexing approach provide investors with efficient, scalable exposure to non-U.S. equities.

Foolish Take

Adventist Health’s latest move reinforces its pivot toward broad, diversified global exposure after also trimming an emerging-market position last quarter. The nonprofit hospital network’s investment arm purchased roughly $38 million worth of the iShares Core MSCI Total International Stock ETF (IXUS) in the third quarter, giving it a new 6.2% portfolio weight. The shift, which coincided with Adventist’s full exit from the iShares MSCI Emerging Markets ex China ETF, suggests a preference for stability and scale over regional concentration as global equities rally.

Adventist Health System West, which manages about $600 million in equity assets to support its $6 billion nonprofit healthcare operation, invests like an institutional endowment—aiming to balance long-term growth and liquidity for hospital expansion and patient services. IXUS offers exposure to both developed and emerging markets outside the U.S., capturing over 4,000 global stocks through a low-cost, passive approach.

For long-term investors, this kind of shift underscores a cautious optimism toward international equities. By reallocating from volatile emerging markets into a broader, diversified ETF, Adventist appears to be positioning for steadier compounding—an approach consistent with its conservative, mission-driven investment philosophy.

Glossary

13F assets under management (AUM): The value of securities a fund manager reports to the SEC on Form 13F.
Form 13F: A quarterly SEC filing required from institutional investment managers to disclose their equity holdings.
ETF (Exchange-Traded Fund): An investment fund traded on stock exchanges, holding assets like stocks or bonds.
Dividend yield: Annual dividends paid by an investment, expressed as a percentage of its current price.
Alpha: A measure of an investment's performance relative to a benchmark, showing excess return or outperformance.
Passively managed ETF: An ETF designed to replicate the performance of a specific index rather than actively select securities.
MSCI ACWI ex USA IMI Index: A global equity index tracking developed and emerging markets outside the United States.
Emerging markets: Countries with developing economies and financial markets, often offering higher growth potential and risk.
Developed markets: Countries with advanced economies and established financial markets.
Core holding: A primary investment intended to form the foundation of a diversified portfolio.
One-year total return: The investment's gain or loss over one year, including price changes and dividends.
52-week high: The highest price an asset has reached in the past 52 weeks.

Jonathan Ponciano has no position in any of the stocks mentioned. The Motley Fool has positions in and recommends Vanguard FTSE Developed Markets ETF and Vanguard S&P 500 ETF. The Motley Fool has a disclosure policy.