Genomics Is the Enterprise's Next Frontier

and HR is at the Helm

Lauren Berkowitz · Jul 14, 2026

Medicine is starting to shift from treating disease to catching risk before it appears. A genomic result can flag a serious inherited risk while a person still feels completely well, moving the starting point of care from treating illness to acting on information. It is a hopeful change, and it is arriving quickly.

The reach is already wide. As many as one in eight seemingly healthy adults may carry a serious inherited risk they do not know about, and that is only what today's testing can identify. Inherited cancer testing once read two genes; standard panels now read thirty to eighty or more. And nearly nine in ten people found to have a serious risk had no idea, because the traditional triggers for testing, including personal and family history, miss many of them.

Society has no agreed language for this yet. Healthy has always meant no symptoms, nothing visibly wrong, and a genomic result splits the word in two: feeling well, and having no known serious risk. A growing number of people live in the gap, well by every measure we use and aware of a risk that reshapes how they read the next twenty years. This is not about good genomes and bad ones. Everyone has some risk, what changed is how much of it a test can see. At work, a colleague who looks well, and is well, may be holding something life-changing and have said nothing.

The shift will increasingly reach people through employer-sponsored coverage, still the largest source of health insurance for working-age Americans and their families. That puts the enterprise close to the center of it, and HR at the helm, because a workforce learning its own genetic risk is a people problem before it is anything else. The result is only the beginning. What a company does next is HR's to shape.

The result itself should remain private, but its consequences do not stay with the employee who receives it. Like an inherited variant traced through a family, from parent to child to cousin, one finding travels its own lines through a company - benefits absorbs the cost, legal weighs the Genetic Information Nondiscrimination Act, managers support someone whose attention may have shifted elsewhere, and finance sees the exposure when treatment runs into the millions. GINA bars employers from using genetic information in employment decisions, but it leaves a real gap - its federal protections do not extend to life, disability, or long-term-care insurance, where a known risk may still affect underwriting.

The frontier extends beyond inherited-risk screening. Fertility benefits may cover embryo testing for a known variant, while cell and genome-editing therapies are creating a new class of high-cost claims. The first CRISPR treatment was approved in the US in 2023. These uses are different, but for employers they converge in benefits, privacy, leave, equity, and trust. Today they affect few employees, that will not remain true.

Most large employers are self-funded, so they bear much of the cost directly. Stop-loss helps with catastrophic claims, but it does not remove the exposure. Two things are true at once: population screening for highly actionable conditions can be cost-effective, while the expanding field of genomic treatment may be extraordinarily expensive. Cell and gene therapies, still rare today, already carry multimillion-dollar price tags, and 71 percent of employers expect them to create significant financial pressure within the next few years. This is not a claim to absorb but a transition to fund and manage over time. Like any major enterprise transformation, doing it well requires early planning.

Genomics is the rare part of the AI era that is unmistakably HR's. The louder part of AI, the agents and copilots, is a crowded room where IT, HR, and new AI committees are staking claims. Genomics crosses benefits, legal, finance, privacy, clinical care, and workforce policy. Advances in sequencing, automation, bioinformatics, and AI have made genetic testing faster, broader, and less expensive, but a genomic result does not resolve to software. It resolves to a person - their health, their family, their standing at work. No function can lead this alone, but HR is the function best positioned to hold the pieces together.

Leading it does not ask HR to become something it is not. Covering the tests is the easy part, and many plans already do it. The hard part is readiness: the manager who does not know what to ask, the leave policy written before preventive surgery existed, the privacy line, the mental load on someone who feels fine. Someone owns the benefit. No one owns the readiness. It is the work HR has always done - preparing managers, designing humane policies, protecting privacy, and keeping people at the center. None of it requires HR to read a genome or see a single result.

The scale of this transformation is easy to understate. Francis Collins, who led the Human Genome Project, put it plainly: "I believe that reading our blueprints, cataloguing our own instruction book, will be judged by history as more significant than even splitting the atom or going to the moon."

Companies today range from unaware to reactive to prepared to leading, and nearly all remain in the first two stages. The results keep going out, a little more common each year, each landing on a person who walks back into a building that has, or has not, prepared for the day. What they meet there is HR's to decide. Move early and the payoff may include better care navigation, fewer avoidable crises, stronger employee trust, and a reputation as a place that takes people's futures seriously, which can influence who joins and who stays. The decision comes first and the program follows, and the decision is simply to lead the shift rather than be led by it.

Sources: prevalence, as many as one in eight on a broad actionable panel from the PREDICT study (Bidwell et al., Genetics in Medicine, 2026, n=484), with larger cohorts finding lower rates, about one in thirty in Geisinger's MyCode (JAMA Network Open, 2025) and one in twenty-five in deCODE's Icelandic cohort (New England Journal of Medicine, 2023). Nearly nine in ten unaware before screening, Geisinger MyCode. Cost-effectiveness of population screening for the three Tier 1 conditions, about $68,600 per quality-adjusted life year for adults under 40, Guzauskas et al., Annals of Internal Medicine, 2023. Seventy-one percent of employers expecting financial pressure from cell and gene therapies, Pharmaceutical Strategies Group, 2026. Projected cell and gene therapy spending near twenty billion dollars a year through 2035, Conti et al., The Milbank Quarterly, 2025. First CRISPR therapy, sickle cell disease, approved 2023.