CVS Caremark was widely criticized in March when word got out that its employees would have to submit to yearly health screenings or pay $50 more a month for insurance.  The pharmacy chain isn’t exceptional:  The Kaiser Family Foundation reports nearly half of US companies with more than 200 employees have wellness programs that measure worker’s weight, blood pressure, blood sugar, and cholesterol.  That number is likely to grow next year, when rules take effect under the Affordable Care Act that give employers more tools to prod workers into healthier behavior.  The law will let companies charge employees who don’t meet certain health targets 30 percent more for insurance premiums, up from 20 percent now.

Chronic conditions such as obesity and diabetes account for three quarters of US health costs, a lot of that money could be saved if Americans took better care of themselves.  Giving incentives to quit smoking or lose weight, the reasoning goes, will help companies tame growing medical costs while making workers healthier. It’s not at all clear that the programs could be used to make sick people pay more, a practice Obamacare was supposed to prevent. “If it becomes a tool for shifting healthcare costs….you might undermine the whole idea of workplace wellness,” says Allan Balch, vp of the Preventive Health Partnership, and alliance of the American Cancer Society, the American Diabetes Association and the American Heart Association.

The share of US companies that reward workers who participate in wellness programs grew to 61 percent in 2012 from 36 percent in 2009, according to a survey by Towers Watson (TW) and National Business Group on Health. Employers spend 2 billion annually on the programs. Often employees receive the incentives just for agreeing to a finger prick and blood pressure check, no matter how the tests turn out. Johnson and Johnson’s wellness program lowers premiums for workers who take screenings and follow up with counselors to improve their health. The Obamacare rules set to take effect next year would allow companies more power to tie the price employees pay for insurance to specific health goals. Workers in such programs would only receive money, or avoid an increase in their insurance costs, if, for example, they keep their cholesterol or weight at certain levels. Those who can’t – because of disability, or because of a predispostion to high cholesterol or diabets – must be given a reasonable alternative to earn the reward, such a attending a seminar on healthy eating.

The rise of wellness programs has been accompanied by a proliferation of medical tests. Public health guidelines recommend cholesterol screening for healthy adults once every five years and screening for diabetes only in people with high blood pressure, absent of other symptoms. Wellness screenings typically test for both annually. “You have to identify and medicate tons and tons of people to prevent one or two from getting sick” says Al Lewis, a former consultant to health plans and employers. Lewis once preached the benefits of wellness management but has become a vocal critic after hoped for savings didn’t materialize. Corporate human resource departments are playing doctor.

The best thing an employer can do for their employees health, is reduce their stress by making their work more rewarding and fulfilling. “If your in a job you hate”, he said “your going to live a short, unhealthy life period.”