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(Fortune Magazine) — Every business has felt the burden of ballooning medical costs, but few have focused as intently on keeping employees healthy as Paychex, the payroll and HR outsourcer based in Rochester, N.Y.

As Paychex CEO Jon Judge explains, “You can’t have an expense item on your P&L that’s growing double digits every year and expect that it isn’t going to choke you.”

So now employees who undergo a confidential health screening and risk assessment and agree to join a smoking-cessation program reap real financial rewards, such as lower deductibles and costs. All plans include free annual physicals, colonoscopies, and 100% coverage of preventive care.