Even though the merger was many years ago, integration is still in an unresolved state. I suspect this will not get resolved for another 7-10 years. Cultural clashes aside, the problems at hand are difficult to solve due to complexity of healthcare and PBM business in general.
And every day, things get more complex as the industry invents more products to shift around cost burden, resulting in further patchwork solutions.
Unfortunately, there is no one in the company that has understanding of the entire breadth and depth of the problems at hand.
Many smart people have already left the company due to stress, poor pay, unjust demotions / promotions, performance management, loss of confidence in leadership. Staggering number of talented people simply walked away on their own in recent year.
The unresolved integration issue puts tremendous amount of burden on almost all employees including service reps, account management, sales rep, project managers, developers, product owners, alike.