Health tech startup Pearl Health raised $110 million in a mix of debt and equity financing to build out its artificial intelligence platform for Medicare providers, including AI agents to handle administrative tasks.
The company, which launched in November 2020, provides technology to help providers deliver preemptive care to Medicare patients through AI-powered predictive insights, financial risk modeling and streamlined workflows. Pearl says it supports a network of over 10,000 providers, including health systems like University of Vermont Health and MDX Hawaii, across over 40 states, caring for over 250,000 Medicare beneficiaries.
The capital raise was comprised of $50 million in equity investment led by Andreessen Horowitz with participation from Viking Global Investors, AlleyCorp and Ulysses Capital, and a $60 million credit facility led by Trinity Capital.
Pearl has raised a total of $125 million in equity to date, including a series B round in 2023.
The company is in a period of accelerated growth as it now manages approximately $3.6 billion in annualized medical spend, up from $2.4 billion the prior year and $1.6 billion the year before that. Pearl is projected to triple its patient base from 2024 through the end of 2026, executives said.
Pearl reached profitability in 2025 while maintaining rapid growth, according to the company.
More than 70 million people are enrolled in Medicare with costs exceeding $1 trillion, Centers for Medicare and Medicaid Services (CMS) data show. Reimbursement is increasingly tied to outcomes rather than utilization, creating strong incentives for providers to prevent avoidable illness, intervene earlier and manage patient populations.
Pearl Health plans to use the fresh capital to expand its AI platform and accelerate its growth across enterprise health systems and payer partnerships.
The company is investing in its Performance Intelligent AI-powered software tool that turns clinical data into actionable, patient-level insights.
"Performance Intelligence will give population health teams and care managers a real-time, natural language interface and reasoning engine for data on total cost of care, quality, and utilization, so they can see which patients need attention first," Michael Kopko, co-founder and CEO of Pearl Health, said via email.
The company also is developing care orchestration AI agents to automate administrative workflows such as annual wellness visit scheduling, post-discharge follow-ups and care management outreach.
"Beyond the platform, we're growing through new enterprise health system and payer partnerships, expanding across the Medicare market, and building new risk offerings. For providers, the benefit is knowing which patients are highest-risk sooner and getting clear, prioritized next steps. For payers and other risk-bearing partners, it means better alignment on quality, utilization, and total cost of care. For patients, it means more quality time with care providers and more affordable care," Kopko said.
"We look at whether our technology helps care teams identify high-risk patients sooner, close care gaps more reliably, and reduce avoidable downstream costs," he noted. Pearl Health is projected to generate $500 million in gross healthcare savings through 2026. "The combination of lower cost and better care is how we define success," he said.
Pearl Health also is expanding into Medicare Advantage and plans to roll out new risk offerings.
"Medicare Advantage enrollment keeps growing, and providers there face a lot of the same risk management challenges we already help solve in traditional Medicare. Entering now lets us bring that same solution to a larger population of patients," Kopko told Fierce Healthcare.
"We’re also seeing strong customer demand for a unified approach across Medicare, allowing organizations to use the same workflows, technology, and operating model across their broader patient panel instead of maintaining separate processes for Traditional Medicare and Medicare Advantage," he noted.
Advances in automation and agentic AI are creating new opportunities to scale those AI-enabled workflows with greater operational leverage, enabling care teams to deliver more personalized, proactive care while reducing administrative burden, Kopko asserted.
"The strategy adapts to what Medicare Advantage requires: deeper claims integration, stronger risk adjustment support, and point-of-care tools built for Medicare Advantage plan structures. We're not starting from scratch, we're extending a system that already works," he said.
For the remainder of 2026 and into 2027, the company is focused on using its technology to help care organizations "consistently deliver better clinical outcomes and stronger financial performance in evolving payment models," Kopko said.
"That means scaling our business, growing our provider network, entering Medicare Advantage, and making our AI tools even more useful in day-to-day care orchestration. Our vision is to be the leading technology platform for Medicare, delivering better health outcomes at meaningfully lower cost," he said.
Investors are showing a strong interest in tech-enabled value-based care and VBC enablement companies. Honest Health banked a $140 million round back in February to expand partnerships and scale programs supporting Medicare members. Chamber Cardio, which builds infrastructure and AI-driven tools to help cardiologists succeed in value-based care arrangements, picked up $60 million earlier this year. Artificial intelligence startup Keebler Health raised $16 million in series A funding to build out its AI-powered infrastructure for value-based care.
In December, value-based care enablement company Aledade secured a $500 million senior secured credit facility to support the company as it continues to scale its business. In September, Strive Health, a value-based kidney care company, scored $300 million in a series D equity round and secured $250 million in debt financing.
As noted with the Strive Health and Chamber Cardio funding rounds, investors are moving beyond broad primary-care VBC plays and into specialty-specific value-based care.
Pearl Health's latest funding shows investors believe tech-enabled value-based care can scale as a real business, Kopko noted.
"Value-based care requires new technology and capabilities that help organizations run more efficiently while keeping patients at the center. Pearl AI is what makes that possible: it expands clinical capacity, connects workflows, and enables earlier intervention. That's the infrastructure providers need to make value-based care successful," he said.
"Pearl has demonstrated that managing risk across large patient populations across many different settings of care can improve patient outcomes, generate meaningful savings, and support a sustainable business model at scale," said Vineeta Agarwala, M.D., general partner at Andreessen Horowitz in a statement. "Pearl's ability to enable providers to participate in value-based payment programs successfully – and to do so through technology, rather than clinical workforce expansion – is a testament to both the vision and execution of the Pearl team."