Pearl Health is an AI-powered technology, services, and financial tools platform that helps primary care providers transition to and succeed in value-based care models for Traditional Medicare and Medicare Advantage. Pulse 2.0 interviewed Pearl Health co-founder and CEO Michael Kopko to learn more.
Michael Kopko’s Background
Could you tell me more about your background? Kopko said:
“I began my career at Bridgewater Associates, where I worked closely with Ray Dalio and the firm’s Chief Investment Officers, helping build and manage the research organization. The experience gave me a deep appreciation for understanding how complex systems work and how data can be used to drive better decisions.”
“From there, I joined Oscar Health in its early days. Having known Josh Kushner since college, I was excited by the opportunity to help build something from the ground up. Over the years, I led several functions including sales, network development, and business operations, helping scale the company through significant growth and ultimately its public offering.”
“Six years ago, I founded Pearl Health with a simple but ambitious goal: to help providers deliver better care by giving them more intelligent insights about their patients. Today, we’re partnering with healthcare organizations across the country to improve outcomes, reduce costs, and bring the promise of value-based care to life at scale.”
Formation Of The Company
How did the idea for the company come together? Kopko shared:
“Pearl was founded out of a shared belief that healthcare could work better for both patients and providers.”
“More than six years ago, I joined Kevin Ryan, Jeff DeFlavio, Ankit Patel, and the team at AlleyCorp to explore how technology and data could help transform healthcare delivery. We were particularly interested in the opportunity to equip providers with better information about their patients and create a more accountable model of care.”
“When we launched Pearl in 2020, our thesis was straightforward: the providers who care for Medicare patients every day are best positioned to improve outcomes, but they need better tools, better data, and better support. We set out to build a platform that could give clinicians the insights and infrastructure they need to intervene earlier, coordinate care more effectively, and deliver better results at scale.”
“That founding vision continues to guide the company today.”
Favorite Memory
What has been your favorite memory working for the company so far? Kopko reflected:
“There have been many memorable moments, but one that stands out is our partnership with BayCare. BayCare serves a large Medicare population in the region of Florida where my family is from, which made the opportunity especially meaningful on a personal level.”
“Large healthcare transformations are never easy. They require trust, alignment, and a willingness to change longstanding ways of working. Together with BayCare, we built a partnership that not only delivered strong results but also demonstrated what’s possible when technology, clinical expertise, and shared purpose come together.”
“For me, it’s a powerful example of why we started Pearl in the first place. Seeing the impact we can have on patients at scale and seeing our team rise to meet that challenge is incredibly rewarding.”
Core Products
What are the company’s core products and features? Kopko explained:
“There are a few ways we work with our clients. First, we help care organizations get into the right Medicare program. Most providers don’t know which risk track fits their patient population, so we use predictive analytics and actuarial modeling to make that call with them. The second piece is performance optimization using our AI platform to continuously monitor patient populations and identify those at risk of an emergency room visit or a hospital readmission. The goal is to get ahead of those events before they happen. The third piece is helping care teams do more without burning out or adding headcount, because everyone in healthcare right now is being asked to stretch further than they should have to. We integrate directly with a number of electronic health record systems, so the workflow fits into how practices already operate, making it significantly easier for them.”
Challenges Faced
Have you faced any challenges in your sector of work recently? Kopko acknowledged:
“Risk is a word that makes a lot of providers uncomfortable, and for good reason. Their whole careers they were paid for the number of patients they saw and procedures they completed. Taking on financial accountability for patient outcomes is a completely different way of thinking, and we have had to earn trust. What we do is we take on some of the downside risk alongside our partners, so they are not walking into these models alone. We have also invested in making our forecasting as accurate as possible so that when we tell a provider what to expect, they can be confident in our assessment. We have also been active in advocating for the broader health of these Medicare programs. For instance, we work with industry partners to identify and stop fraud. These are the types of challenges that will never fully disappear but we make them easier to navigate.”
Evolution Of The Company’s Technology
How has the company’s technology evolved since launching? Kopko noted:
“The evolution has been dramatic. In the early days, our technology focused primarily on organizing patient information and helping providers better understand the populations they were responsible for managing.”
“Today, we’ve built a platform that not only supports independent practices but also some of the country’s largest health systems and provider organizations. At its core is a sophisticated prediction engine that helps identify potential health events before they occur, allowing providers to intervene earlier and more effectively.”
“What’s most exciting, however, is that we’ve moved beyond prediction. Healthcare has never lacked insights about what should happen next, it has struggled to execute those actions consistently and cost-effectively. Pearl’s technology helps bridge that gap by translating predictions into workflows, outreach, and interventions that can be completed at scale.”
“Just as importantly, we’ve invested heavily in creating a user experience that clinicians genuinely enjoy using. The result is a platform that makes care delivery more proactive, more intelligent, and ultimately more impactful for both providers and patients.”
“AI is embedded throughout our platform. We use machine learning and predictive models to identify emerging patient needs, large language models to synthesize complex clinical and operational information, and agentic technologies to help coordinate the actions required to address those needs.”
“These capabilities allow us to automate and augment tasks such as patient outreach, scheduling, communication, and care coordination. Rather than being limited by available labor, providers can extend their reach and engage patients more effectively at scale.”
“Ultimately, we see AI as a way to help healthcare organizations move from knowing what should happen to actually making it happen. That’s where the greatest opportunity exists to improve outcomes and reduce costs.”
Customer Success Stories
Can you share any specific customer success stories? Kopko highlighted:
“One of the most rewarding aspects of our work is seeing organizations achieve meaningful results through value-based care.”
“Earlier, I mentioned our partnership with BayCare, which has been an outstanding example of what’s possible when providers, technology, and operational teams align around better patient outcomes.”
“We’ve also seen success across a wide range of organizations. For example, Redirect Health in Arizona partnered with us early in its value-based care journey and was able to scale significantly over the following years. At the enterprise level, we work with organizations facing complex population health challenges, helping them reduce avoidable hospitalizations, improve care coordination, and ensure patients receive the right care in the right setting.”
“While every partnership is different, the common thread is helping providers proactively manage patient populations and improve outcomes at scale.”
Funding/Revenue
Are you able to discuss funding and/or revenue metrics? Kopko revealed:
“We’ve raised more than $100 million in equity financing to date and have additional credit facilities that support our continued growth.”
“Our business is built around the Medicare populations we help manage on behalf of providers. In 2026, we’re on track to manage approximately $3.4 billion in annualized medical spend, up from roughly $2.4 billion the prior year and approximately $1.1 billion the year before that.”
“That growth reflects both the expanding number of provider partners we serve and the increasing role technology is playing in helping healthcare organizations succeed in value-based care.”
Differentiation From The Competition
What differentiates the company from its competition? Kopko affirmed:
“Our biggest differentiator is our belief that the future of healthcare will be driven by intelligent, proactive technology rather than simply adding more people to the process.”
“Pearl combines deep patient data, advanced AI capabilities, and a broad network of providers (including independent practices, specialists, and health systems) to help identify patient needs before they become costly health events. We believe that much of what happens in Medicare is increasingly predictable, and if it’s predictable, it can often be prevented or mitigated through earlier intervention.”
“Rather than relying on additional administrative layers, our technology is designed to help providers take the right action at the right time with greater efficiency and consistency. By combining predictive intelligence with scalable execution, we’re building a system that enables more proactive, preventative, and cost-effective care for patients.”
Future Company Goals
What are some of the company’s goals? Kopko concluded:
“At the highest level, we’re building a talent-driven company. With a team of roughly 135 people, every individual has an outsized impact on our success. Recruiting, developing, and retaining exceptional talent remains one of my most important responsibilities as CEO.”
“From a business perspective, our goals are centered on growth and performance. We want to expand the number of provider organizations we serve across Medicare and Medicare Advantage while continuing to improve the economics of healthcare.”
“Today, our platform helps generate meaningful savings across the medical spend we manage. Looking ahead, we’re building toward a future where we manage between $5 billion and $7 billion in healthcare expenditures while removing hundreds of millions of dollars of unnecessary costs from the system. If we’re successful, we’ll not only create value for our partners but also help make healthcare more affordable and effective for the patients who depend on it.”
