# Promoting Access to Payment Pathways for Emerging Molecular Diagnostics

> **NIH NIH K01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2024 · $205,418

## Abstract

PROJECT SUMMARY / ABSTRACT.
In the era of precision medicine, molecular diagnostics (MDx) can deliver unprecedented opportunities for
individualized approaches to care and improve clinical outcomes. Yet, the pace of precision medicine discovery
has far exceeded the rate of implementation; consequently, MDx implementation across populations, diseases,
and clinical settings is uneven, and disparities persist. Disparities stem from complex and multilevel barriers, but
research indicates that patient-facing cost barriers are the biggest challenge for emerging MDx, where clinical
guidelines are evolving and payer coverage is uneven. For many conditions, prompt MDx results are essential
for personalized treatment approaches to improve outcomes, but barriers that prevent or delay payment for MDx
testing can result in either mistreatment or delayed treatment. Institution-level interventions that facilitate access
to MDx payment pathways and work towards increasing coverage for MDx will improve patient outcomes and
guide effective, ethical, and equitable precision medicine implementation. However, developing strategies to
increase MDx access requires new approaches to (1) empirically examine payment pathways to MDx access
and (2) identify and characterize the range of institutional resources that best promote access to MDx payment
pathways. The proposed research achieves this objective by using a case study of circulating tumor DNA (ctDNA)
testing for lung cancer patients; the specific aims are:
Aim 1: Analyze differences in patient-level factors associated with different payment pathways for MDx.
Aim 2: Define institution-level resources associated with promoting access to MDx payment pathways.
Aim 3: Identify and prioritize institution-level interventions that are promising candidates to promote equitable
access to MDx payment pathways.
The project will provide a knowledge base to understand and improve disparities in access to MDx payment and
generate timely evidence to guide more equitable PM implementation. The training plan for the project builds on
my expertise in conducting interdisciplinary research to identify PM disparities. It expands my range of qualitative
(advanced skills in narrative elicitation) and qualitative data (advanced machine learning and natural language
processing [NLP] skills to analyze electronic health record [EHR] data) to conduct rigorous mixed methods
research. Comprehensive training and mentoring in health services research, health policy, clinical genetics,
health disparities, and implementation science will enable me to effectively translate study findings into effective
strategies to promote precision medicine access. The skills and knowledge gained from the training will inform my
R01 and lay the foundation for developing practices and policies that can have a significant impact on reducing
disparities in precision medicine.

## Key facts

- **NIH application ID:** 10948766
- **Project number:** 1K01HG013687-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Emily A Hammad Mrig
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $205,418
- **Award type:** 1
- **Project period:** 2024-08-07 → 2029-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10948766

## Citation

> US National Institutes of Health, RePORTER application 10948766, Promoting Access to Payment Pathways for Emerging Molecular Diagnostics (1K01HG013687-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10948766. Licensed CC0.

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