The $250 Million Question: What Is Employee Health Really Worth?

Bank of America is spending more than $250 million annually on GLP‑1 medications for its employees – an expense CEO Brian Moynihan calls a good investment. Other major employers, including PwC, Cigna, HCA Healthcare, and Starbucks, are reducing or withdrawing similar coverage because of its escalating cost. The same intervention is being viewed either as an investment in employee health or as an expense that may be impossible to sustain.

The cost of prevention is immediate, visible, and easy to calculate. Its return may take the form of a heart attack that never occurs, a disability leave that is avoided, or a chronic illness whose progression is delayed.

The company paying for that prevention may not capture its full return. Some benefits may appear years later, after an employee has moved to another organization. Yet companies continuously inherit employees whose health has been either protected or neglected elsewhere. Investment – and neglect – can circulate through the workforce.

GLP‑1s (see the I-phone moment of medicine) have brought this dilemma into focus, but it extends to every investment in prevention whose benefits are delayed or difficult to see – from early screening to mental-health care.

Investment in a healthier workforce could therefore become a virtuous cycle, but only if enough organizations are willing to support benefits that are delayed, shared, and valuable not merely because people work better, but because they live better.

The Corporate Divide

Bank of America’s decision to spend more than $250 million annually on GLP‑1 medications represents one view of employee health: the expenditure is an investment whose value can include better health, fewer medical events, and reduced absenteeism. The company also provides coaching and monitoring, recognizing that medication alone is not a complete health strategy.

PwC, Cigna, and HCA Healthcare have withdrawn similar coverage for weight management, while Starbucks has announced plans to do so. Their decisions reflect another legitimate reality. Rapidly increasing demand and potentially long-term treatment can create costs that even large employers struggle to sustain. A 2026 survey found that 36% of corporate employers cover GLP‑1s for both diabetes and weight management, while 60% limit coverage to diabetes. Companies are examining the same development but defining its value differently.

Prevention’s Accounting Problem

The cost of prevention appears immediately in a budget. Its return may arrive years later as a cardiovascular event that never occurs, a disability leave that is avoided, or a chronic illness whose progression is delayed. Prevention is therefore difficult to value because some of its greatest successes leave no event to count.

A 2026 National Bureau of Economic Research working paper provides one indication of the potential return. Researchers using Danish data found that GLP‑1 treatment reduced long-term sickness absence by 17.3%. Denmark’s employment and healthcare systems differ from those of the United States, and the finding does not prove that coverage will pay for itself in every organization. It does show why medication costs alone provide an incomplete calculation.

We are moving from treating employee health as a benefit to recognizing it as long-term human capital – but our accounting systems remain far better at measuring the cost of care than the value of prevention.

When the Return Changes Employers

Even when prevention works, its benefits may emerge after the employee has changed jobs. The company paying today may protect someone’s health while another employer benefits years later. From the perspective of the original company, the return appears to have been lost.

But companies do not only lose employees in whom they have invested. They also recruit people whose health was supported elsewhere. An organization may not capture the full return from every investment it makes, but it can benefit from investments made by others. Health protection can move with people through the labor market.

The same is true of neglect. Companies also inherit the consequences of risks that previous employers failed to address. What one organization leaves untreated may eventually affect another through illness, disability, absence, or rising healthcare needs.

Companies therefore continuously inherit one another’s investments – and one another’s neglect.

From Individual Cost to Collective Return

This movement creates the possibility of a virtuous cycle. When enough organizations invest responsibly in prevention, they contribute to a healthier workforce from which many can benefit. What appears to be an isolated expense within one company can become part of a wider, shared return.

However, every company also has an incentive to wait for others to make the investment. If each employer focuses only on the benefits, it can capture directly, prevention will remain undervalued. The cycle depends on organizations recognizing that some returns circulate rather than remain within the company that created them.

More Than Productivity

A healthier workforce can mean fewer absences, lower disability costs, and more sustained participation in work. These outcomes matter, particularly when healthcare spending must compete with other organizational priorities.

But employee health cannot be valued only through its contribution to performance. People are not valuable simply because illness makes them less productive. Some health investments are worthwhile because they improve business outcomes; they also matter because preventing illness and extending healthier lives have value in themselves.

GLP‑1s have made this tension unusually visible, but it extends to cardiovascular prevention, cancer screening, mental-health care, sleep disorders, and early intervention. The larger leadership question is whether companies can recognize the value of prevention when its most important returns are delayed, shared, or impossible to see precisely because the investment succeeded.

Final Thoughts

Prevention asks companies to invest today in benefits they may not fully capture tomorrow. Yet employers continuously inherit employees whose health has been either protected or neglected by others.

If enough organizations participate, those investments can circulate through the workforce and create a shared return: healthier people, healthier companies, and healthier lives.