More than 80 percent of the nation's largest employers may soon increase financial pressure on workers to maintain greater health, as permitted under new federal health care legislation.

As part of the Affordable Care Act of 2010, the Obama administration issued final rules this week on employee wellness programs, through which employers providing health insurance steer workers toward healthier behaviors — and hopefully healthier outcomes.

A recent survey by the Midwest Business Group on Health shows employers such as Ford Motor Company, Walgreen, and Boeing will soon implement policies incentivizing healthier behaviors such as enrolling in wellness programs. The administration also provided businesses with final rules for financial penalties for workers engaging in unhealthy behaviors, such as smoking and living a mostly sedentary lifestyle.

"This reinforces that employers have been on the right track in using financial incentives as one approach among many to influence health," Andrew Webber, president and chief executive of the National Business Coalition on Health, told the media. "We're supportive of the wellness rules and increasing the amount of incentives that employers can use in trying to influence employee behavior."

Many employers had been waiting for clarification on rules to implement new policies. "We see the regulations as a stimulus to spur employer innovation as it encourages them to push for more effective programs that achieve their business objectives, while improving the health of their employees," said Derek Yach, vice president of the Vitality Institute, a company which specializes in employee wellness programs.

Among the clarifications, the administration softened expectations for outcome-based health programs, such as smoking cessation or weight-loss programs. Such behavioral changes, such as overcoming an addition, sometimes requires a "cycle of failure and renewed effort," the administration wrote. In such programs, employers might incentivize workers to participate in a plan that might have graduated expectations from one year to the next, entitling a worker to a financial reward for attending a smoking cessation seminar in the first year without absolute guarantee of success.

The administration said the same for programs incentivizing workers to either lose or maintain weight.

"The regulations are likely spur innovation among employers, practitioners, and academics in the field," Yach said. "But they also place an appropriate burden of accountability and fairness on programs which claim to improve health."

The new rules are available online.