Pearl Health
Pearl Health is a value-based care enablement platform that helps primary care providers succeed in Medicare risk-bearing contracts through AI-powered patient prioritization, workflow automation, and aligned financial incentives. It serves health systems, physician networks, and independent primary care practices across 40+ U.S. states.
- Company typePrivate
- Founded2020
- HeadquartersNew York, United States
- Headcount101–250
- GTM typeB2B
- OfferingSoftware
What Pearl Health does
Pearl Health is a value-based care enablement platform that helps primary care providers succeed in Medicare risk-bearing arrangements. Founded in 2020 and headquartered in New York, the company operates as both a risk-bearing ACO entity (Pearl ACO under ACO REACH and MSSP) and a SaaS technology provider, allowing customers to choose between full risk partnerships, technology-only deployment, or a hybrid. Pearl targets three customer segments: health systems and IDNs (e.g., BayCare, Holzer, Hudson Headwaters), physician networks and IPAs/MSOs (e.g., Santé IPA, Virginia Care Partners/HCA, MDX Hawaii, PraxisCare/Adaugeo), and independent primary care practices. As of February 2026, the platform supports 275,000+ Medicare beneficiaries across 5,000+ providers, 3,000+ facilities, and 40+ states, with $3.4 billion in Medicare healthcare premiums managed.
Pearl's core technology is the "Pearl Platform," an AI-native operating system that ingests structured healthcare data (Medicare Advantage claims, ADT feeds, and EHR records) and feeds it through its proprietary Signal-Action Framework — an algorithm that converts data signals into prioritized, EHR-embedded next-best actions for clinicians. Named proprietary models include the post-discharge predictive AI (validated to reduce readmissions 17% and identify high-risk patients 4x more effectively) and an applied mean reversion forecasting model that reduces forecast error by 63 basis points versus naive trend-forward approaches. The platform integrates ambient AI documentation through a DeepScribe partnership and embeds STARS/HEDIS quality measures for Medicare Advantage workflows. Pearl is HITRUST r2 certified (March 2025) and HIPAA-compliant.
Pearl generates revenue through three streams: aligned risk contracts and shared-savings arrangements under ACO REACH and MSSP (managed services); SaaS technology enablement contracts (recurring subscription); and performance-aligned incentive distributions, with implementation advances and predictable monthly payments. Pricing is custom and quote-based, scaled to provider network size and selected Medicare program. The company employs roughly 135 people across hubs in New York, Boston, and Seattle, and is backed by Andreessen Horowitz (lead investor across Series A and Series B) and Viking Global Investors, with $93 million in total disclosed funding (an $18M Series A in September 2021 and a $75M Series B in January 2023). Pearl has also built a flagship thought-leadership franchise through its annual Top 50 Value-Based Care Thinkers Report (in its fifth year in 2026) and annual Primary Care Pulse surveys.
Pearl Health firmographics
Firmographics- Name
- Pearl Health
- Legal name
- Pearl Health, Inc.
- Website
- https://pearlhealth.com
- Company type
- Private
- Founded year
- 2020
- Operating status
- Operating
- Headcount range
- 101–250 employees
- Short description
- Pearl Health is a value-based care enablement platform that helps primary care providers succeed in Medicare risk-bearing contracts through AI-powered patient prioritization, workflow automation, and aligned financial incentives. It serves health systems, physician networks, and independent primary care practices across 40+ U.S. states.
- Ownership category
- akta.pro rank
Pearl Health industry classification
Industry- Product category
- Value-Based Care Platform
- NAICS
- Health Care and Social Assistance (62), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (5182)
- SIC
- Services-Health Services (8000), Services-Prepackaged Software (7372)
- akta.pro primary industry
- Software as a Medical Device (SaMD) – Clinical Decision & Diagnostic Software (HLACANAD)
- akta.pro secondary industry
- EHR/EMR Integration & Interoperability Middleware (HL7/FHIR) (HLALAKAD)
Keywords
Where Pearl Health is headquartered
LocationHeadquarters
- HQ city
- New York
- HQ country
- United States
- HQ region
- North America
Offices4 records
Markets served
Pearl Health business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Personnel, Technology or R&D, Marketing or Sales, Operations
Revenue model
- Aligned Risk Contracts / Shared Savings (Risk-Bearing ACO Operations): Pearl enters into aligned risk partnerships where it shares in savings and downside with providers in ACO REACH and MSSP programs. Pearl manages both ACO REACH and MSSP populations; receives implementation advances, predictable monthly payments, and performance-aligned incentives; uses actuarial modeling to match providers to risk tracks. Geographic scope: 40+ U.S. states.
- SaaS Technology Enablement: Pearl also offers the platform as a SaaS technology deployment (separately or combined with risk contracts) to health systems, physician networks, and primary care practices. The "Partnership Design" stage explicitly offers "SaaS technology deployment" as an option. Revenue is recurring/contract-based.
- Performance-Aligned Incentive Distributions: Pearl's incentive structure rewards performance directly and predictably — transparent distribution rules ensure top performers capture the full value of their results, building accountability and trust. Also provides implementation advances and predictable monthly payments.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Multi-year contract | Custom partnership-based pricing — quote required; entry point is a free complimentary roster / opportunity analysis. |
Go-to-market motion4 records
Distribution channels5 records
Marketing channels11 records
Pearl Health product offering
Product offeringCore offering
Pearl Health provides an AI-native value-based care platform that ingests claims, ADT feeds, and EHR data to surface prioritized patient signals and embed next-best actions into provider workflows. It sells the platform as SaaS technology enablement to health systems, physician networks, and primary care practices, and also participates as a risk-bearing ACO in ACO REACH and MSSP arrangements, sharing savings and downside with partner providers across 40+ U.S. states.
Product overview
Pearl Health operates as a single integrated platform-plus-modules architecture centered on the Pearl Platform, an AI-native "operating system for value-based care." The Pearl Platform is the foundation that powers the Signal-Action Framework, which ingests claims, ADT feeds, and EHR data to generate prioritized clinical signals and automate next steps. Layered on top are Pearl's three customer-facing program offerings — Pearl for Traditional Medicare, Pearl for Medicare Advantage, and Pearl ACO risk pools — which are delivered through role-specific solutions for Health Systems, Physician Networks, and Primary Care Practices. Annual editorial publications (the Top 50 Value-Based Care Thinkers Report and the Primary Care Pulse Report) and complementary programs like the Insight Partner Program extend the platform's reach into thought leadership and provider co-creation. All are accessed through the secure Pearl Health web application at app.pearlhealth.com.
Differentiator
Problem solved
Functional benefit
Products and services
- Pearl Platform AI-native value-based care platform that combines claims, ADT feeds, and EHR data with predictive analytics and workflow automation to help providers identify high-urgency patients, automate next steps, and improve performance across risk-bearing Medicare contracts. Sold to health systems, physician networks, IPAs/MSOs, and primary care practices across 40+ U.S. states.
- Pearl for Traditional Medicare Program offering that helps providers succeed in Traditional Medicare ACO REACH and MSSP risk arrangements through portfolio design, cash-flow smoothing via implementation advances and predictable monthly payments, shared savings maximization, and AI-powered care enablement. Targeted at health systems, physician networks, and primary care practices.
- Pearl for Medicare Advantage Program offering that integrates MA claims with real-time data feeds to surface prioritized patient insights, embedded STARS/HEDIS measures for gap closure, point-of-care EMR integration, and multi-pronged benchmark accuracy support for risk adjustment. Designed for providers and payers serving Medicare Advantage populations.
- Pearl ACO REACH / Pearl MSSP (Risk-Bearing ACO Programs) Risk-bearing ACO programs operated by Pearl Health that allow primary care providers to participate in ACO REACH and MSSP under Pearl's ACO entity, sharing in savings and downside while accessing implementation advances, predictable monthly payments, and the Pearl Platform.
Quantifiable outcome
- 1–3% medical loss ratio improvement in year one
- +7 more outcomes
Companies that use Pearl Health
Customer profileNamed customers15 records
Segments5 records
Ideal customer profiles4 records
Pearl Health technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration5 records
AI capability4 records
Feature9 records
Pearl Health partnerships and signals
Strategic signalPartnerships
19 partnerships are on record, tiered flagship regional partner, integration partner, regional expansion partner, flagship customer-partner, flagship payer partner, specialty partner, thought leadership partner and partner network.
- Virginia Care Partners (HCA Virginia Affiliate)flagship regional partnerPearl Health and Virginia Care Partners (an HCA Virginia Affiliate) established a partnership to expand access to value-based care, providing technology, insights, and financial tools for primary care providers in the Richmond area. Quote from Gerard Filicko, Executive Director.
- DeepScribeintegration partnerDeepScribe and Pearl Health announced a partnership to bring ambient AI documentation and point-of-care intelligence to value-based care providers, particularly primary care clinicians participating in ACO REACH and other risk-bearing models.
- PraxisCareregional expansion partnerPearl Health partnered with PraxisCare and Adaugeo Healthcare Solutions to expand its value-based care network in the Pacific Northwest, enhancing value-based care for Medicare ACOs with cutting-edge technology to improve patient outcomes. Quote from TK Kennedy, CEO of PraxisCare.
- Adaugeo Healthcare Solutionsregional expansion partnerJoint partnership with Pearl Health and PraxisCare to expand value-based care network in the Pacific Northwest, enhancing value-based care for Medicare ACOs with technology to improve patient outcomes.
- MDX Hawaiiregional expansion partnerPearl Health partnered with MDX Hawaiʻi to enhance primary care in Hawaii, providing data insights, financial tools, and value-based services for better patient outcomes and lower costs. Quote from Dr. Manoj Mathew, CEO of MDX Hawaii.
- BayCare Health System (BayCare Plus)flagship customer-partnerPearl Health partnership deepens BayCare Plus's tech enablement capabilities, allowing its network of clinicians to deliver quality patient care. Quote on homepage from Shawn Armstrong, President of BayCare Plus.
- Holzer Health Systemflagship customer-partnerPartnered with Pearl Health to increase access to value-based care in Ohio and West Virginia through advanced data insights, financial tools, and provider enablement technology. Quote from Rodney Stout, MD, President & CEO.
- Santé Physicians / Santé IPAflagship customer-partnerPearl Health's technology platform enables Santé Physicians to better identify and manage high-risk and rising-risk patients, improve quality performance, and optimize PCP revenue potential. Quote from Dr. Michael Synn, CMO.
- Hudson Headwatersflagship customer-partnerPearl partnership supports Hudson Headwaters' whole-person health innovation and community partnerships to improve health outcomes, patient satisfaction, and overall care coordination. Quote from Brittany Silvestri, EVP & COO.
- Wellcare (Centene Corporation)flagship payer partnerPearl Health (a leading technology company focused on physician enablement and risk-bearing in value-based care) and Wellcare (the Medicare brand of Centene Corporation, NYSE: CNC) announced a partnership to advance value-based care in collaboration with primary care physicians.
- Synapticurespecialty partnerSynapticure and Pearl Health partnered to provide specialized neurologists and personalized patient and caregiver support to Medicare patients with dementia through the CMS GUIDE program, offering behavioral health support and comprehensive caregiver services nationwide.
- Isaac Healthspecialty partnerIsaac Health and Pearl Health announced a strategic partnership to deliver the CMS GUIDE Model, streamlining dementia care for patients and supporting unpaid caregivers to improve quality of life.
- MNSspecialty partnerPearl Health and MNS partnered to equip skilled nursing facilities for success in value-based care by combining technology, virtual oversight, and aligned reimbursement to improve outcomes and reduce hospitalizations.
- Vimintegration partnerPearl and Vim partnered in a hackathon to integrate Pearl Platform insights into EHR workflows, creating a new Vim feature in 72 hours. Vim Connect is a developer platform and application marketplace for integrating healthcare solutions into care team workflows.
- Conduce Healththought leadership partnerPearl Health featured Conduce Health in a Q&A on building bridges between PCPs and specialists in value-based care — spotlighting innovative specialist engagement models.
- Shore Quality Partnerspartner networkPearl Health partner — listed among "world's top companies" trust logos on Pearl Health's homepage and partner pages.
- Praxis Healthpartner networkPearl Health partner — listed among "world's top companies" trust logos on Pearl Health's homepage and partner pages.
- BlueSky MDflagship customer-partnerBlueSky MD uses Pearl's model to utilize care teams more effectively and get credit for activities performed. Quote from Dr. David LaMond, CEO & Medical Director.
- Odibo Medical Groupflagship customer-partnerIndependent primary care practice partnered with Pearl to improve patient outcomes, reduce costs, and grow the practice. Quote from Dr. Michael Odibo, Physician & Owner.
Scale indicators15 records
Recent moves6 records
Expansion highlights7 records
Pearl Health competitors and assessment
Company assessmentDirect peers
- Aledade: Aledade operates the largest independent network of primary care ACOs, providing ACO REACH/MSSP enablement technology, risk-bearing infrastructure, and practice transformation services to PCPs — the closest functional and business-model analog to Pearl.
- Agilon Health: Agilon Health partners with primary care physicians to take global risk for Medicare Advantage populations via a capitated, technology-enabled model — directly comparable to Pearl's risk-bearing, PCP-anchored VBC enablement motion.
- Privia Health: Privia Health enables physician networks and IPAs to participate in value-based care arrangements across multiple payers, combining practice enablement technology with risk-sharing — overlapping Pearl's IPA/MSO and physician network customer segments.
- Stellar Health: Stellar Health provides a VBC enablement SaaS platform that translates payer data into EHR-embedded, point-of-care actions for PCPs in risk contracts — a direct functional competitor to Pearl's Signal-Action Framework for ACO REACH/MSSP providers.
- Wellvana: Wellvana partners with independent primary care practices to take on Medicare risk through ACO REACH and MSSP, offering technology, care management, and shared-savings economics — competing head-to-head with Pearl in the same end markets.
- VillageMD: VillageMD (a Walgreens Boots Alliance portfolio company) operates value-based primary care clinics and provider enablement for risk-bearing Medicare contracts — a competing model for PCP-led VBC, particularly in risk-bearing ACO arrangements.
- Astrana Health (formerly Apollo Medical Holdings): Astrana Health partners with independent medical groups and IPAs to manage Medicare Advantage and ACO risk populations, combining capitated arrangements with technology-enabled care management — a direct competitor in the VBC enablement space.
Broad incumbents
- Evolent Health: Evolent Health is a publicly traded value-based specialty care and population health company serving health plans and providers — a broader incumbent with overlapping VBC enablement capabilities but at much larger scale and payer-led.
Emerging players
- Innovaccer: Innovaccer offers a healthcare data activation platform and value-based care suite for providers, payers, and ACOs, intersecting with Pearl's data aggregation, risk stratification, and care management workflow capabilities.
Others
- Vim: Vim is a developer platform and EHR-integrated application marketplace for value-based care point-of-care workflows; Pearl has integrated with Vim Connect via a hackathon, and Vim is an adjacent/partner player in the same EHR-embedded VBC workflow ecosystem.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat6 records
Key risks6 records
Key highlights7 records
Customer concentration
Pearl Health social profiles
Digital presencePearl Health compliance and trust
Trust signalCompliance3 records
Pearl Health financial estimates
Financial estimateRevenue estimate
Valuation estimate
Pearl Health leadership team
Management profileNumber of profiles
Profiles10 records
Pearl Health funding detail
Funding detailFunding overview
Funding rounds7 records
Investors9 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Pearl Health M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Pearl Health
What does Pearl Health do?
Pearl Health provides an AI-native value-based care platform that ingests claims, ADT feeds, and EHR data to surface prioritized patient signals and embed next-best actions into provider workflows. It sells the platform as SaaS technology enablement to health systems, physician networks, and primary care practices, and also participates as a risk-bearing ACO in ACO REACH and MSSP arrangements, sharing savings and downside with partner providers across 40+ U.S. states.
Is Pearl Health a public or private company?
Pearl Health is a private company. It is classified as venture growth investor backed and is currently operating.
When was Pearl Health founded?
Pearl Health was founded in 2020. It employs 101 to 250 people.
Where is Pearl Health based?
Pearl Health is headquartered in New York, United States, in the North America region.
How does Pearl Health make money?
Three revenue lines are on record. Aligned Risk Contracts / Shared Savings (Risk-Bearing ACO Operations) is the primary driver. The others are saaS Technology Enablement and performance-Aligned Incentive Distributions.
Who are Pearl Health's main competitors?
Direct peers on record are Aledade, Agilon Health, Privia Health, Stellar Health, Wellvana, VillageMD and Astrana Health (formerly Apollo Medical Holdings). Evolent Health is listed as a broad incumbent. Innovaccer is listed as an emerging player. Vim is listed as an others.
Does Pearl Health have an API?
No public API is recorded for Pearl Health.
What industry is Pearl Health in?
Pearl Health's product category is Value-Based Care Platform. Its primary akta.pro industry code is HLACANAD, Software as a Medical Device (SaMD) – Clinical Decision & Diagnostic Software, with a secondary code of HLALAKAD, EHR/EMR Integration & Interoperability Middleware (HL7/FHIR). Its NAICS code is 62 and its SIC code is 8000.