CVS splitting off its pharmacy business is a good sign: one company shouldn't be the clinic, the pharmacy, and the business all at once.
When one entity does all three, it's hard to say who a decision is really for. The patient? The margin? Nobody can tell from the outside.
At Happy Head, the line is simple. Board-certified dermatologists make every prescribing decision. I run the business. I'm a nurse by training with an MBA, and I still don't get a vote on what a patient is prescribed.
That's the version of this I'd want every health company to copy. Say who makes the clinical call. Say who makes the business call. Put it where customers can read it.
Conglomerates were built to capture more of the patient's dollar. Clear lines are how you earn their trust.