(From U.S. News)—Your bosses want you to eat your broccoli, hit the treadmill and pledge you'll never puff on a cigarette. But a new study raises doubts that workplace wellness programs save the company money.

In what's being called the most rigorous look yet inside the wellness trend, independent researchers tracked the program at a major St. Louis hospital system for two years. Hospitalizations for employees and family members dropped dramatically, by 41 percent overall for six major conditions. But increased outpatient costs erased those savings.

The study in Monday's issue of the journal Health Affairs has implications for a debate now taking place at companies around the country: how much pressure can you put on workers to quit smoking, lose weight, and get exercise before it turns into unwelcome meddling, or worse, a slippery slope toward a new kind of health discrimination?

Wellness programs started out offering gym memberships and modest cash rewards for participating in a health assessment focused on changing bad habits. But employers have been upping the ante, linking the programs to insurance discounts or penalties that can add up to hundreds of dollars.

Most major companies now have wellness programs, and smaller firms are signing up. President Barack Obama's health overhaul law allows employers to expand rewards and penalties, provided workers are also given a path to address lifestyle issues that could undermine their health.

"The immediate payback in terms of cost is probably not going to be there," said economist Gautam Gowrisankaran of the University of Arizona at Tucson, lead author of the study. But he noted there could be other benefits not directly measured in the study, such as reduced absenteeism and higher productivity.

And there's also a risk. "It's definitely true that there is a downside," Gowrisankaran said. "You are going to be charging people different rates based on their wellness behavior, and that could limit their ability to buy health insurance."

Obama's law forbids insurers from charging more if you get sick. But wellness incentives could mean you'd be penalized for the questionable choices that might get you sick.

Some previous studies have shown savings from wellness programs, while others found little change or even higher spending.

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