Farzad Mostashari, Co-founder and CEO, Aledade

Farzad Mostashari is co-founder and chief executive of Aledade, the company that helps independent primary care practices form accountable care organizations and earn money by keeping patients healthy and out of the hospital. Before that he ran the federal office that moved most American hospitals onto electronic health records, and he left it convinced that the records alone had not changed outcomes.

From Iran to Upstate New York

He was born in Richmond, Virginia, and raised in Iran, where his strength in science, math, and computers earned respect. At 14 he moved to upstate New York to live with an aunt, expecting those talents to make him popular there too. Classmates mocked him instead, and he kept at it.

He earned a bachelor's degree in biochemistry from Harvard in 1989, a master's in population health from the Harvard T.H. Chan School of Public Health in 1991, and a medical degree from Yale in 1996.

Medical school left him feeling like an insider and an outsider at once, a feeling he ties to his bow tie. "I knew that I was asking questions that other people weren't. I knew that I didn't feel like I totally fit in," he said in 2024.

Investigating Disease Outbreaks

After an internal medicine residency at Massachusetts General Hospital, he joined the Epidemic Intelligence Service of the Centers for Disease Control and Prevention and was posted to the New York City Health Department. "On my first day at the job in the New York City Health Department I showed up a little late and Emily, my boss said, 'There's a foodborne outbreak, go investigate it,'" he recalled. He became lead investigator in the West Nile virus outbreak, and after the 2001 anthrax mailings he used data patterns to build early warning signals. With Martin Kulldorff he developed SaTScan, free software that looks for clusters of disease in geographic and hospital data.

Bringing Records to Primary Care

In 2005, under health commissioner Thomas Frieden, he started the city's Primary Care Information Project, which helped doctors' offices, community health centers, and hospitals install electronic health records. Those systems came to cover more than 2 million patients, three quarters of them on Medicaid or uninsured.

Running Federal Health IT

After Congress passed the HITECH Act, David Blumenthal recruited him as deputy national coordinator for health information technology in July 2009, and he succeeded Blumenthal as national coordinator on April 8, 2011. He oversaw Stage 1 of Meaningful Use, which distributed $27 billion in federal stimulus funds to doctors and hospitals that installed electronic records and showed they used them. Over those years, by his count, the share of hospitals on electronic records went from 9 percent to 90 percent.

The goal he cared about most did not move. Blood pressure control did not improve, and the Million Hearts program he helped start did not prevent a million heart attacks and strokes. He left during the government shutdown in October 2013, put his badge on his desk, and rode his bicycle home past the Washington Monument. He may have shed a tear, he said, "and it wasn't from pride, it was from the feeling that I had kind of won the battle, lost the war."

Founding Aledade

"This idea had me by the lapel," he said of the plan that followed: if prevention paid better than treatment, "then everything changes." He left government on a Friday and started as a visiting fellow at the Brookings Institution's Engelberg Center for Health Care Reform the next Monday.

Nine months at Brookings, spent with health plans, hospitals, and independent physicians, produced what he calls the paradox of primary care leadership. Independent practices were best placed to lead value-based care, yet had the fewest resources to do it alone. He laid out the plan in JAMA and co-founded Aledade in 2014, starting from a list he wrote on his first day home: "get docs, get contracts, get savings, get capital." The name comes from the part of an astrolabe that points to the North Star.

Aledade partners with existing practices and does not build or buy clinics. "We added more than 500 practices in 2025, and we added more than 700 practices in 2026," he said.

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