This is a candidate-led profitability case focused on diagnosing why the addition of a large dental chain (Eastern Dental) has caused Alfa Dental's profits to decline despite increased volume. The case teaches diagnostic thinking about cost-revenue misalignment in partnership/network models and strategic pricing decisions. The key insight is that Eastern Dental's rapid growth in patient visits—driven by successful business strategies—is increasing Alfa's costs (fee-for-service payments) faster than their fixed insurance premium revenues grow.