This is not so much of a "con" or disadvantage, but the organization is going through a culture change. I have worked in several companies that experienced very rapid growth and change. It can be challenging to incorporate new employees, new ideas, new methods, etc. Employees with longer tenure may often have difficulty adapting to changes and it may take newer employees a while to adapt to the existing culture and fit in. The best companies try to take the best of the old and new and position an organization to handle rapid growth and change. In my opinion, the pros greatly outweigh the cons. I am able to speak with my manager about anything at any time. During these periods of change, open, honest communication is the key. My advice to everyone is to address the issues head-on in a constructive way. Speak with your manager. If we can't communicate directly, it's impossible to move forward. Change is necessary as companies grow. It's important to participate and provide direct feedback and help to shape the culture you want to see at CAQH.