Challenges with Defining Pharmaceutical Markets and Potential Remedies to Screen for Industry Consolidation.

Context: Dramatic increases in pharmaceutical merger and acquisition (M&A) activity since 2010 suggest we are in the midst of a third wave of industry consolidation.

Methods: The authors reviewed 168 economic, legal, medical, industry, and government sources to examine the effects of consolidation on competition and innovation and to explore how industry attributes complicate M&A regulation in a pharmaceutical context.

Findings: The authors find that, in spite of certain metrics that might argue otherwise, consolidation consistently reduces innovation and harms the public good.

Evaluating inpatient adverse outcomes under California's Delivery System Reform Incentive Payment Program.

Objective: The California Delivery System Reform Incentive Payment Program (DSRIP) provided incentive payments to Designated Public Hospitals (DPHs) to improve quality of care. We assessed the program's impact on reductions in sepsis mortality, central line-associated bloodstream infections (CLABSIs), venous thromboembolisms (VTEs), and hospital-acquired pressure ulcers (HAPUs).

Data Sources: We used 2009-2014 discharge data from California hospitals.