For employees at Clarian Health, feeling the burn of trying to lose weight will take on new meaning.

In late June, the Indianapolis-based hospital system announced that starting in 2009, it will fine employees $10 per paycheck if their body mass index (BMI, a ratio of height to weight that measures body fat) is over 30. If their cholesterol, blood pressure, and glucose levels are too high, they’ll be charged $5 for each standard they don’t meet. Ditto if they smoke: Starting next year, they’ll be charged another $5 in each check.

Clarian has been making headlines for its aggressive and unusual approach to covering escalating health-care costs. Rather than taking the more common step of giving employees incentives for merely participating in its wellness programs, such as joining a smoking cessation group or using a health coach, Clarian is actually measuring outcomes. And unlike most employers, it is penalizing workers for poor health instead of rewarding them for taking healthy steps. “More Transparent”

But some employment lawyers and wellness program administrators believe Clarian’s approach may not be so unusual in coming years. They see employers, already overwhelmed by rising health-care costs, getting more aggressive in mandating changes in employee behavior. Garry Mathiason, a senior partner at employment law firm Littler Mendelson, says more than 300 companies have requested its assistance on mandatory wellness initiatives since it released a study on the topic in April. “In reality, you only get a certain amount of participation with incentive and encouragement,” he says. “The demand for [curtailing health-care costs] is so great that [employers] are willing to take the next step. It’s tough love.” As BusinessWeek chronicled in February, some outlier companies have even banned tobacco use for its employees altogether (see BusinessWeek.com, 2/26/07, ).

In addition, regulations that became effective July 1 could prompt cautious employers to step off the sidelines. The federal government recently issued final rules on how wellness programs could comply with the nondiscrimination conditions of the Health Insurance Portability & Accountability Act (HIPAA). While the new regulations have been proposed for years, the final rules provide employers with some sense of security and more clarification on how much they can reward or penalize employees based on specific health results. “When you get into things that involve discrimination, employers aren’t very comfortable with the words ‘proposed regulation,’” says Jerry Ripperger, director of consumer health for the Principal Financial Group, a financial-services and insurance firm that offers wellness programs for large employers.

The final regulations were a major catalyst for Clarian Health’s new program. Steve Wantz, Clarian’s senior vice-president of administration and human resources, says his team had been considering their plan for two years, but the new regulations “gave us a lot more confidence.” Another change in Indiana state law that allowed employers to offer financial incentives or surcharges to smokers in their health plans was also an impetus. After benchmarking other companies, Clarian, which had already been encouraging employees to join smoking cessation programs and take health risk tests, decided charging employees was more “transparent.” Other companies “were providing what they called incentives through credits or discounts toward health premiums,” says Wantz. “What we found was what those employers were doing, many times, was raising their premiums and discounting them back.” Sticks and Carrots

At Clarian, employees who have blood pressure that’s above 140 over 90, blood glucose levels over 120, low-density lipoprotein cholesterol over 130, or a BMI over 29.9 could be subject to the paycheck deductions. Of the company’s 13,000 employees, about 8,000 are enrolled in the company’s health plan. The company estimates that as many as 34% of its employees will meet the definition of being obese, while it expects lower levels for other health measures. About 26% are tobacco users. The fines are waived for employees who can provide a doctor’s note stating it’s not advisable for them to try to meet the benchmark—employees will be able to submit new notes from their doctors quarterly—and that they are complying with the proper diet, exercise, and treatment plan.

SAN FRANCISCO: Apple on Wednesday unveiled new versions of its best-selling iPod media player with touch screens and video games, giving its chief executive, Steve Jobs, new gadgets to entice buyers during the holiday shopping season.

The company will add a new iPod Shuffle and a smaller iPod Nano to its lineup, Jobs said at an Apple event called “The Beat Goes On.” The new Nano, available in five colors, features a 2.5-inch, or 6.4-centimeter, screen for watching movies and playing games like a Sudoko program developed by Electronic Arts. Prices will start at $149.

Apple also said it would introduce a new version of its iTunes music software. Customers will now be able to buy ring tones for 99 cents and add them to their iPhones.

Computer users have downloaded more than 600 million copies of iTunes, said Jobs, who wore his trademark black turtleneck and jeans.

Jobs typically unveils new iPods to spur orders in the last three months of the year, one of Apples biggest sales periods. The iPod, along with sales of songs and videos through the companys iTunes store, accounted for more than a third of its revenue last quarter.

Aside from the June release of the iPhone, which combines the media player and a mobile phone, Apple had not updated the iPod in almost a year.

Shaw Wu, an analyst with American Technology Research in San Francisco, said, “Over the holidays, the iPod and accessories can contribute as much as half of their revenue or more.”

Apples introduction of the $79, clip-on iPod Shuffle in October helped drive iPod shipments to a record 21.1 million units during the 2006 holiday season.

Since then, Jobs has added the iPhone, which features a 3.5-inch, color touch screen.

Shares of Apple fell $2.89, or 2 percent, to $141.27 in afternoon trading on the Nasdaq Stock Market after investors were apparently disappointed about the upgrades.

Apple has sold more than 100 million iPods since 2001, when it introduced the device. It is the best-selling digital media player in the United States, with about a 70 percent share of the market, according to the NPD Group, a market research firm based in Port Washington, New York. Apples iTunes is also the most popular site providing legal music downloads, NPD added. Microsoft cuts Zunes price

Microsoft cut the price of its 30-gigabyte Zune digital media player to $199, a $50 reduction, The Associated Press reported from Seattle.

“Its part of the normal product life cycle, something weve had on the books for months,” wrote Cesar Menendez, a Microsoft employee, on the companys Zune Insider blog.

Blood traces found in the holiday apartment where Madeleine McCann was sleeping the night she disappeared did not come from the missing girl, it was reported today.

Analysis of the tiny spots of blood found smeared on the bedroom wall showed it belonged to a man, according to the Times.

The test results come after a fortnight of mounting speculation that the four-year-old girl was murdered in the Praia da Luz apartment.

The results showed that the blood probably came from a man from the “north-east European sub-group”. This conclusion is only 72% accurate, however, due to the poor condition of the sample because of its age and cleaning of the bedroom wall.

The Forensic Science Service in Birmingham is now conducting further tests on the blood traces.

A male guest is known to have injured himself while staying at the flat after Madeleine disappeared. This could explain why the blood was not found when Portuguese police searched the apartment after Madeleine’s disappearance.

Recent reports in the Portuguese media have quoted anonymous police sources as saying that detectives believe Madeleine died in the apartment the night she went missing.

A spokesman for the Policia Judiciaria said yesterday that they were now working on the assumption that Madeleine is dead. But Inspector Olegбrio Sousa said they had not entirely ruled out other possibilities.

Kate and Gerry McCann have clung to the hope that their daughter is still alive during the 105 days since she vanished while they ate dinner with friends at a nearby restaurant.

But Mrs McCann has said she would rather know if her daughter was dead than remain in limbo for the rest of her life.