By 2011 there was a notable shift from healthcare management provision to emphasis on non-medical products for HR and call centers. Quality became all about time management over outcomes. Products were not updated to meet new ways to engage the clients' employees. As contracts were not renewed, layoffs became more frequent and those positions were not replaced. Currently there are only two or three disease management nurses to serve the remaining clients. It has become quite obvious that Carewise Health has changed direction. Although I am a healthcare professional and not a business person, I am not blind to the fact that the company must remain viable. However, as layoffs continue, tactics such as a December demand forcing the use of accrued paid time off before the end of the year have been instituted. Longtime workers have been targeted for layoff, suggesting an interest in purging the company of more expensive employees. If you are a medical professional applying for a position at Carewise, make sure you investigate and question the company's current mission and position regarding your expertise and that it fits with your vision of your future. In the early days I felt valued and fulfilled, but by the time I left I realized that corporate viability had become more important to the leadership than caring for clients and their employees.