Genetic Testing as Part of Workplace Wellness Programs

by Allison Higgins, an Independent Health and Productivity consultant and Mary Hiter, director of Marketing at Interleukin Genetics

Designing competitive benefit packages that help you attract and retain top talent can be daunting.  While health and well-being benefits may only represent a small portion of your overall compensation plan, they can drive a disproportionate share of your budget.  Could the introduction of genetic testing as a covered benefit allow you to better manage your healthcare spend?  With the promise of continued increases in your healthcare premiums, perhaps now is the time to seriously consider using genetic testing in order to offer more personalized benefits.

What Is Genetic Testing and How Valuable Is It?

Genetic testing has been around for half a century and according to the National Institutes of Health, there are more than 1,000 genetic tests in use today with more being developed daily.  Genetic testing is simply a type of medical test that can identify DNA changes in chromosomes, genes or proteins in the body.

The results of a genetic test can confirm or rule out a suspected genetic condition, help determine a person’s chance of developing or passing on a genetic disorder, or determine risk of developing specific health conditions.  Recent advances in genetics have made it possible to identify individuals at increased risk for major chronic diseases, opening the door to individualized prevention strategies and early detection and treatment.  These advances hold great promise for improving health and in some instances can actually reduce healthcare costs.

A genetic test is most valuable when you can take action based on the results.  Take for example phenylketonuria (PKU) which is caused by inheriting a certain gene from both parents.  PKU screening is now mandatory for all newborns and is administered with a simple blood test.  A positive test allows the immediate action of strict dietary treatment to prevent amino acid build-up, which preserves brain function and prevents mental delay.

The majority of common diseases that Americans encounter do not result solely from a single gene but result from the interaction of multiple genes and genes interacting with environmental factors including diet and lifestyle.  Consequently—except in rare genetic diseases—a genetic test alone cannot solely predict whether a person will develop a chronic disease or not, but can provide added risk information specific to an individual’s genetic makeup.

There are a few important regulations to be aware of before using a genetic test.  Employees are most frequently concerned about whether they will be required to take a genetic test: genetic testing should never be mandatory.  Employees should also receive information on the positive and negative implications of the test they will be taking.  Similarly, employees should be reassured that their information will not be shared or used without their consent and the employer will not have access to their personal genetic data.

The U.S. has two specific laws that provide protection against the unwanted sharing of personal health information and protection against discrimination.   In 2008, the Genetic Information Nondiscrimination Act (GINA) was passed to protect Americans from being treated unfairly because of differences in their DNA.

GINA allows individuals to get genetic tests that could improve their health, or to participate in research without fear that their DNA information might be used against them for health insurance or by their employer.

In addition to GINA, the Health Insurance Portability and Accountability Act (HIPAA) of 1996—and the ensuing “Privacy Rule” that went into effect in 2003—protect personal health information from being misused or shared without consent.  In today’s world of electronic medical records, and the need to pass health information from provider to provider and provider to insurer, the HIPAA Privacy Rule ensures the individual is protected during that flow of information.

When Can Genetic Testing Be Used to Positively Impact Employee Health and Wellbeing?

There is significant value in offering a genetic test to employees when knowing that a genetic marker exists that allows an individual to work with their healthcare provider to proactively manage risks or directs specific treatment plans to improve health outcomes.

Additionally, in some instances genetic tests may allow for improvement in benefit design based on an increased risk.  Although GINA prevents insurers from denying or pricing healthcare based on genetic information, this information can be used to improve healthcare benefits.

An example of this stems from research in the prevention and treatment of periodontal disease.  Individuals who test positive for the Interleukin-1 (IL-1) gene variation are genetically predisposed to develop more severe periodontitis, which can often result in increased chronic inflammation.  When inflammation persists it can lead to serious health conditions such as diabetes and heart disease.

By identifying individuals who are positive for the IL-1 gene variation and providing them with expanded, more intensive dental care benefits, one can also better manage the onset of periodontitis, and thereby reduce the potential for other chronic health conditions and related healthcare costs.  The use of a simple genetic test allows employers to identify their at-risk employees and provide a precision benefits package that offers personalized care in order to delay the onset, and progression, of costly chronic diseases.

Employers who are looking to retain their top performers, and keep them healthy, should consider incorporating genetic testing into their wellness programs—it will benefit everyone in the long run.