Pearl Health, a healthcare technology company helping providers manage risk for Medicare patients, announced Wednesday that it secured $110 million in funding.
The New York-based company supports clinicians and care organizations in engaging in value-based care by offering AI-powered predictive insights, financial risk modeling and more efficient workflows. Its platform helps identify at-risk patients so providers can intervene early, and helps automate administrative processes like scheduling and post-discharge follow-ups.
The $110 million raise includes a $50 million equity investment led by Andreessen Horowitz with participation from Viking Global Investors, AlleyCorp and Ulysses Capital, as well as a $60 million debt facility led by Trinity Capital.
“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, MD, 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.”
With the funding, Pearl will expand its AI platform, as well as continue to grow via new health system and payer partnerships, and expand into Medicare Advantage.
Pearl Health currently supports more than 10,000 providers across 40 states, serving more than 250,000 Medicare beneficiaries. The company manages about $3.6 billion in annualized medical spend, an increase from $2.4 billion the year before, according to the announcement. The company is expected to provide $500 million in gross savings, as well as triple its patient base from 2024 through the end of 2026.
More than 70 million people are covered under Medicare, and costs top $1 trillion in the system, the announcement states. Pearl aims to reduce costs by helping providers tie reimbursement to outcomes versus volume.
“Pearl was founded on a simple belief: healthcare should reward keeping people healthy, not just treating them when they are sick,” said Michael Kopko, co-founder and CEO of Pearl Health, in a statement. “Unnecessary costs and poor outcomes persist in US healthcare because most providers lack the capabilities to shift to outcomes-based care alone. With this financing, we are investing in accelerated innovation and growth to expand our impact across the healthcare system.”
Other companies helping providers engage in value-based care include Aledade and Astrana Health.
Photo: Richard Drury, Getty Images
