The unchanging playbook to build a high growth company
People ask me what it takes to build a high-growth company, with a rapidly growing footprint and enterprise value. They want the formula, a secret, or a shortcut. There isn’t one. But there is a playbook. And after more than 13 years leading organizations across the healthcare spectrum, I can tell you that the playbook does not change. The industry or sector changes. The team changes. The product changes. But the playbook does not. I have led two companies onto the Inc. 5000 list. The first was EmpiRx Health, a pharmacy benefit management (PBM) company that I took from early stage to a scaled, nationally recognized tech-enabled PBM. The second is OnMed, where we grew revenue 3,500% in a little over two years, deploying care infrastructure into communities left behind by traditional medicine. Two different companies with two different problems, but the same playbook. THE NORTH STAR BECOMES YOUR AIR The most dangerous thing a leader can do is assume the team understands the mission. They do not. The North Star has to be communicated so often, so clearly, and so consistently that it stops feeling like communication and starts feeling like the air everyone breathes. At OnMed, that North Star is simple: quality, affordable, equitable care for every person, in every community, regardless of ZIP code. That is not marketing language, but the operating principle behind every partnership, product, and hiring decision we make. When a team member faces a hard call, they should orient themselves against that North Star without asking me. If they cannot, I have failed at my job. BUILD FOR THE JOURNEY, NOT THE DESTINATION The obsession with outcomes is the single biggest trap leaders fall into. Outcomes matter, but they are the result of doing the right things, the right way, relentlessly—not of chasing the outcome itself. When you organize around outcomes, you start cutting corners. You make decisions that look good on a scoreboard but erode the foundation underneath you. Every c