In order for the benefits of molecular pathology to outweigh its inherent costs, the procedures must be integrated into the assessment of the total disease management to realize the true impact of their financial and clinical outcomes. Major financial and patient outcome benefits are achievable from molecular testing by the ability to reduce the use of less-sensitive and less-specific tests and cause a decrease the use of unnecessary diagnostic procedures and ineffective therapies. In this review, the financial and patient care determinants of outcomes for molecular-based testing of disease predisposition, screening, early detection, and directed therapy are presented.