Doist
For many(if not all) small and medium size business time and cost matter a lot.
That's why languages, frameworks, tools, and services that are easy to use and provide 0 to productive in less time, it's best.
Maybe Node.js frameworks might provide better features compared to Rails but in terms of MVPs, for us Rails is the leading alternative.
Amazon EC2 might be cheaper and more customizable than Heroku but in the initial terms of a project, you need to complete configurationos and deploy early.
Advanced configurations can be done down the road, when the project is running and making money, not before.
But moving fast isn't the only thing we care about. We also take the job to leave a good codebase from the beginning and because of that we try to follow, as much as we can, style guides in Ruby with RuboCop and in JavaScript with ESLint and StandardJS.
Finally, comunication and keeping a good history of conversations, decisions, and discussions is important so we use a mix of Slack and Twist