So what are employers actually after when they implement wellness programs tied to large financial incentives? Cost-shifting. Under the ACA, wellness programs are a legal way to shift a significant portion of the cost of premiums onto employees deemed unhealthy. Wellness programs don’t save money by preventing expensive medical claims—and in fact, they might even increase claims costs due to encouraging unnecessary doctors’ visits. But wellness programs can save money if enough employees fail them or opt out. Workplace Wellness Programs Are a Total Sham