He grew up at a dinner table full of doctors and chose a different scalpel: data. Now he tells hospitals what their surgeries actually cost - and whether they were worth it.
The economist among surgeons. Boston, MA.
Both of Derek Haas's parents are doctors. So are both of his siblings. He calls himself the black sheep. While the rest of the family learned to read an X-ray, he learned to read a balance sheet, and somewhere along the way he noticed the two skills almost never talked to each other.
Today he runs Avant-garde Health, a Boston company that does something hospitals have spent a century avoiding: it puts a real, defensible number on what a single surgery costs, then sets that number next to how the patient actually did. Cost on one axis, outcome on the other. The space between them is where Haas built a business.
He did not start in scrubs or in a garage. He started inside Harvard Business School, where he was a Project Director and Fellow working alongside two of the most cited names in management: Michael Porter, who gave the world competitive strategy, and Robert Kaplan, co-inventor of the balanced scorecard. Their shared obsession was value-based health care - the radical idea that you should measure medicine by the outcomes that matter to patients, divided by what it costs to deliver them. Haas turned that idea into software.
Role: Founder & CEO, Avant-garde Health
Based: Boston, Massachusetts
Schooling: Harvard (BA, MBA)
Before this: Bain & Company, Council of Economic Advisers, MA Inspector General's office, HBS
Claim to fame: Nine Harvard Business Review articles
I am the black sheep of my family - both my parents and both my siblings are doctors - and so I grew up hearing a lot about how our health care system has and has not worked well.- Derek Haas, on why he built a company instead of a practice
Most health-tech founders beg for a pilot. Haas opened the doors with a dozen paying customers already inside - a head start he still describes as "very unusual." The demand had been building while he was still a researcher, watching hospitals realize they could not answer a simple question: what does this cost?
The engine under Avant-garde Health is a mouthful - Time-Driven Activity-Based Costing, or TDABC - co-developed by Haas's own advisor, Bob Kaplan. Strip away the jargon and it is almost stubbornly simple: watch what happens to a patient, who does it, and how long it takes. Multiply by what each minute costs. That is the price of care, built from the floor up instead of guessed from a billing code.
It sounds like accounting. It behaves like a flashlight. Suddenly a surgeon can see that two colleagues doing the same operation produce wildly different costs for the same result - and the cheaper one is not cutting corners, just cutting waste. As Haas puts it, the company does not practice medicine. It hands clinicians a mirror.
Illustrative of the platform's focus, not reported figures.
The Porter-Kaplan creed that Haas carried out of Harvard reads like a math problem: value equals outcomes divided by cost. For decades hospitals could only see the bottom of that fraction, and only roughly. The top - did the patient get better, stay out of the hospital, get back to their life - lived in a different system entirely, if it was measured at all.
Avant-garde Health's bet is that you cannot improve what you refuse to put in the same sentence. Its platform, CareMeasurement, drags cost, process and outcome onto one screen. The company spent seven years building it out, area by area, until it covered every surgical and procedure-based service line.
Most digital-health founders arrive from medicine or from code. Haas arrived from economics and government. He had advised on national policy and chased waste for a state watchdog before he ever sold a line of software.
That detour is the whole point. He is fluent in the language of the people who sign hospital checks, not just the people who hold scalpels - and value-based care lives exactly at that border.
"We are not doctors. Rather, we help doctors and administrators understand the implications of their choices so they can make more informed decisions."
- On the company's role"Getting people to change how they deliver care is a big undertaking."
- On the actual hard part"Our mission is to empower healthcare providers with the best possible insights to enable them to continually improve the cost and quality of their care."
- On the mission"Entrepreneurship is a long journey and the people you partner with are a big part of the success."
- On choosing investorsAsk Haas what he is proudest of and he does not reach for the funding number or the customer count. He reaches for the fact that clients have stayed for seven years - through a pandemic that gave every hospital in America a reason to cancel a software contract, and most of them did. Avant-garde Health's did not.
It tracks with how he describes the work itself: slow, persistent, allergic to hype. Changing how a surgeon operates is not a sale, it is a campaign. The company coaches its clients through the change rather than dropping a dashboard and walking away. In an industry that has buried a graveyard of analytics tools nobody opened twice, "they kept using it" is the rarest endorsement there is.
His ambition runs past his own company. Haas has talked about creating industry standards for the data, metrics and methods of value-based care - the boring, durable plumbing that outlasts any single product. It is a fitting goal for a man whose company is named Avant-garde: out front, where the view is best and the footing is worst.
Operating rooms are the most expensive real estate in a hospital and the least understood. A single procedure pulls in surgeons, anesthesiologists, nurses, implants, drugs and recovery time, each billed by a different system that never reconciles with the others.
That tangle is exactly why Haas aimed there. The bigger the mess, the more a clear number is worth.
For all the talk of artificial intelligence and gene therapy, American medicine still cannot reliably tell you what a hip replacement costs to deliver, or why the same operation costs one hospital twice what it costs the one across town. The bills exist. The true cost does not - at least not in a form anyone can act on.
Haas built his company on that gap. Bundled payments, in which an insurer pays one fixed price for an entire episode of care rather than itemizing every gauze pad, were spreading through the industry, and they put hospitals in a bind they had never faced. For the first time, the difference between a procedure's price and its true cost landed on the provider's books. You cannot manage that margin if you cannot see it. Avant-garde Health sells the seeing.
The work is unglamorous on purpose. There is no consumer app, no viral moment, no patient swiping through a feed. The customer is a surgeon who already believes they are doing fine and a finance team that suspects otherwise, and the product's job is to get those two people looking at the same screen without anyone feeling accused. Haas has spent a decade refining that diplomacy, which is why he talks about coaching clients through change rather than simply shipping them a tool.
Nine Harvard Business Review articles is an unusual line on a CEO's resume. It signals someone who thinks in frameworks and publishes his reasoning in the open, the way researchers do. But Haas is not a professor who wandered into a startup. He raised venture money, hired a team, survived a pandemic and rolled out a platform across every service line a hospital runs.
The two halves of him reinforce each other. The researcher gives the company its credibility - this is not another dashboard vendor, it is the commercial arm of an idea that two of the most respected minds in management spent years developing. The founder gives the research its teeth, dragging elegant theory into the friction of actual hospitals where change is slow and skeptics are many. When he chose Fulcrum Equity Partners to lead his Series A, he singled out their experience as operators, not their checkbook. He wanted partners who had run things, because he knows that the distance between a good idea and a working company is measured in years.
It is a patient way to build, and an unfashionable one. Avant-garde Health did not chase a hype cycle or pivot toward whatever was raising money that quarter. It kept its head down, added one care area at a time, and let a seven-year client relationship do the talking. In a sector littered with flashy launches and quiet shutdowns, that restraint is the strategy.