Large companies in the US are worried that federal requirements in the Affordable Care Act will limit the effectiveness of their employee wellness programmes.

Ratified in 2013, the Affordable Care Act allows employers to offer programmes that reward or penalise employees who don’t meet specific health goals, such as lowering blood sugar, weight or cholesterol.

An association of chief executive officers of US companies with a combined US$7tn (€5.7tn, £5tn) in annual revenue – known as the Business Roundtable – say the schemes are open to abuse and inequalities as even workers who don’t meet a specific health outcome can qualify for the incentives.

This group of companies are issuing a report calling for more flexibility for employer wellness programmes.

According to the federal requirement, staff may qualify for incentives if they participate in alternative options such as reading a book, taking an online course or having a discussion with a nurse.

Companies who offer financial incentives for meeting wellbeing goals – including these alternative options which don’t require staff to improve their health results – say these rules will not curb mounting healthcare costs.

More than two-thirds of employers with at least 50 employees and a workplace wellness programme use financial incentives to encourage programme use, according to a 2013 report by Rand Corp. Ten per cent use incentives tied to health-related standards, such as rewards for reading a book.