By Shane Reeves, CEO, TwelveStone Health Partners
Last week, I had the opportunity to lead a New Employee Orientation with an exceptional group of new team members joining TwelveStone. Participants logged in from Tennessee, Georgia, Virginia, Kentucky, and Mississippi—some stepping into roles at our infusion centers, others beginning work remotely from their homes.
As I spoke with them, I found myself returning to a question I’ve asked many times as our organization has grown: How do we continue to scale as a company without feeling bigger to the people doing the work every day?
Growth is a gift, but it brings responsibility. At TwelveStone, our goal has never been to simply get larger. Our goal is to build a company that delivers more impact while remaining deeply human—connected, accountable, and close to the people we serve and the people we employ.
One organization I’ve long admired for getting this right is Chick-fil-A. Despite operating thousands of locations, the experience often feels local and personal. Decision-making lives close to the customer. Teams take ownership. Leaders stay connected. The “how” is consistent, but the people—the “who”—still shine through.
As TwelveStone continues to grow, that’s exactly the kind of organization we are committed to being: a larger company that still feels small.
To do that well, there are several principles we must consistently protect.
First, decision-making must stay close to the problem.
The best decisions are almost always made by the people closest to the work—the patient, the referral partner, the schedule, the chair, the medication, the moment. We will continue to push decision-making down to the point of service, with clear guardrails, so we can move faster and serve better. If you’re closest to the problem, you should be closest to the solution.
Second, we build the company around teams.
We don’t want to feel like a large machine. We want to feel like a network of strong, connected teams. Great teams create trust, clarity, and momentum. As we grow, we will continue to organize around teams that have real ownership, simple scoreboards, and the ability to improve processes without unnecessary handoffs.
Third, leaders must remain accessible.
In a small organization, leaders are visible, reachable, and quick to listen. We are committed to protecting that. Leaders at TwelveStone are expected to stay connected to the real work. And even as CEO, I want every team member to know that I am always available when needed.
Fourth, we standardize the “how” while personalizing the “who.”
To scale responsibly, we must be consistent in how we deliver care—our processes, safety standards, quality expectations, and communication rhythms. That consistency creates reliability. But we never want to standardize people. Individual strengths, personalities, and styles matter. Our standards should create freedom for people to show up fully as themselves.
Finally, we protect our culture by insisting on alignment with our Purpose Statement and Core Values.
Culture doesn’t protect itself—especially during growth. Skills can be taught. Processes can be improved. But alignment around purpose and values is non-negotiable.
Our aim is not simply to grow bigger. It is to grow better—more connected, more responsive, and more faithful to what we are building together.
Thank you for the care you provide, the way you support one another, and the pride you take in doing things the right way. Let’s continue building a company that, no matter how large it becomes, always feels close—because it is built on teams, trust, and purpose.
