I posted this reply in a private forum elsewhere, but I felt it was a reasonable to put the ideas out there for the public – so I’m posting it here as well.
The question was about the impact of GINA (Genetic Information Nondiscrimination Act of 2008) on wellness programs and incentives. I ramble a little – but you should be used to that by now…
“I’ll start by saying that I’m not a GINA expert, nor am I an attorney, so please don’t base a legal defense on my thoughts…
As I understand it, the biggest problem with GINA and wellness programs revolves around the use of family history as a risk factor. However, when we look at the items that we may address through a wellness program, there are a large number of items that aren’t contingent on family history.
Let’s take a step back – the real goal of wellness programs, at least from a corporate side, is to reduce costs. There are two factors that generally contribute to those costs: conditions and behaviors. In general, once someone has a condition, it’s something that they have to manage for life. So our goal turns to detecting the condition early enough to prevent a catastrophic event (this detection is where family history helps) and managing the condition to prevent a costly disease progression or event. Certainly this side of our program must be concerned with GINA.
The balance of the program, and some might argue the real place to get “bang for the buck”, has to do with behaviors. This includes items like tobacco cessation, weight management and activity programming. Unless I’m missing something, these items should be clear of GINA concerns (unless you are offering these programs based on family history).
So, to the point of your question, providing a wellness program is still possible under the GINA regulations, especially if you concentrate on modifying behaviors and steer clear of using patient history as criteria for inclusion or incentives.
I’d love to hear thoughts from others…”