Bovine respiratory disease complex (BRDC) is one of the costliest ailments in cattle feeding. Often cattle do not manifest symptoms until 15 to 20 days on feed. BRDC causes reduced feeding efficiency, lower average daily gain, and sub packing plant characteristics. A preventative intervention for high risk cattle is metaphylaxis, otherwise known as mass medication. While mass treatment of high risk cattle lowers death loss, net return and return risk impacts of alternative animal health treatment strategies have not been adequately quantified. This studies estimates the net feeding returns under different health strategies and risk category for cattle fed from 1989 to 2008 and 2014 – 2015 comprising over 42,000 observations. Monte Carlo simulations and net return feeding equations were used to develop net return distributions under baseline scenarios. Results suggest that removal of mass medication greatly increases the variation in feeding returns between risk categories. There are clear trade-offs between cattle risk category and health management practice. As public scrutiny of antibiotic use in feedlots continues to grow, a body of research needs to be developed assessing the economic and societal welfare impacts of eliminating arrival metaphylaxis in US feedlots.