By Ricardo Alonso-Zaldivar

Associated Press

WASHINGTON (AP) — 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?

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.

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.

The new study provides an in-depth look at the experience of BJC HealthCare, a hospital system that in 2005 started a comprehensive program linked to insurance discounts. BJC currently employs 28,000 people and provides health insurance for about 40,000, including family members. The overwhelming majority participated in the wellness program.

The study tallied up BJC’s medical costs before the wellness program and for two years after. It also compared those costs with expenses of two other big local employers that did not have wellness programs. That was done to control for the possible impact of new drugs or medical innovations.

The results were counter-intuitive: A surprisingly large drop in hospitalizations for the six conditions targeted by the wellness program, but increased costs for medications and outpatient visits.