SV Angel Founder Profile Series: Michael Kopko — Pearl Health

9 min readMay 30, 2023


We are proud to feature Michael Kopko, Co-Founder and CEO of Pearl Health for the May 2023 SV Angel Founder Profile Series.

Pearl Health is democratizing access to value in healthcare by offering software and services that help providers reimagine how they visualize, understand, and care for their patients. Over the past year, more than 800 primary care providers across the country partnered with Pearl Health, which resulted in more than 10x year-over-year growth. In January 2023, Pearl Health announced a $75M Series B funding round. Prior to founding Pearl Health, Michael was an executive at SVA portfolio company Oscar for over seven years and led the team that helped generate Oscar’s first 125,000+ members and first $1B in premium. We hope you enjoy learning a bit about Pearl Health and the lessons learned along the way.

Pearl Health Co-Founder and CEO Michael Kopko

Name: Michael Kopko

Hometown: New York, New York

Company Name & Brief Description Blurb: Pearl Health is democratizing access to value in healthcare. Pearl supports primary care organizations and providers in their transition to value-based care and surfaces data and insights that help them deliver better, more proactive care, decrease total cost of care across patient panels, and optimize performance in risk-bearing models.

Year Founded: 2020


Q: What was the impetus for starting Pearl Health? Tell us about the moment you decided to start the company.

In October of 2020, I received a phone call from Jeff De Flavio to see if I wanted to start a company in Direct Contracting. It offered the opportunity to help primary care doctors improve their economics, build a more direct relationship with their patients powered by real data and intelligence, and encouraged more accountability and cost reductions in healthcare by building and implementing better technology. Most importantly the government had an active policy agenda to drive this through all of Medicare, which, beyond being the ‘payor’ with the greatest reach to providers across the US, generally catalyzes change throughout the industry. I couldn’t resist.

Q: Tell us the story behind Pearl Health?

Pearl Health was formed in late 2020 to help providers — especially primary care doctors — change their own outcomes in healthcare and help improve the quality and cost of care for their patients. We formed the company in partnership with Kevin Ryan, Jeff De Flavio, and Ankit Patel in order to help lower the cost of care and bring more power and capability to physicians and providers. Over the next decade, we believed that more compensation and reimbursement models in healthcare would move toward value (vs. fee for service) and that enabling physicians would produce success in those models.

Q: What’s a really difficult part about being a founder that no one talks about?

It’s a great question. I find my job and role to be a great honor and privilege, so I don’t often feel “woe is me.” I think these missions are hard and success isn’t a guarantee.

I like to be honest about the hard parts and the easier parts, but I think at the end of the day most of the great successes from entrepreneurship come from the fact that an amazingly talented group of people decide to make something a reality despite the odds.

I think that truth is far less appreciated. People think it’s an idea or luck or resources, but in my mind, it’s really sustaining a great group of people on an important problem with a great culture for long enough that you can break through to levels the world hasn’t seen.

Q: Given the many demands you’ve all had as founders, how do you allocate and prioritize your time daily? Any tips you’d give to other founders?

I’m currently working long days. Emails typically start around 7:30 am, and I typically sign off just before midnight. I only do it because I enjoy it and it’s all building toward something, so I don’t feel like I’m working the same way it might feel for others. If I didn’t feel that way, my “schedule” would be impossible. In general, we try hard to take weekends off as a team. I believe in the restorative process of some time away and time spent with family and friends. Even though we work hard, it’s important that people “relax hard” too.

In the morning I usually work out. For me, exercise is critical and highly related to my mood throughout the day. I’ll have a coffee in the morning and spend some time with my two daughters: Charlotte and Victoria. They’re my greatest gift in the world.

I make an effort to take a few 5–10 minute breaks throughout the day to move around and will make an effort to get home to see my kids before bed.

Every day I also try to write three appreciations, something I’m thankful for. This simple technique, which I’ve been doing for many years, helps me start my day with thanks and optimism, instead of agitation or disappointment.

I’m probably doing too many meetings right now, but I’m committed to being available and up-to-speed with what’s going on across Pearl and beyond. That said, this is something I’m thinking more about — and how to balance it with the increasing demands on my time.

I often use a paper journal to write down insights and important things, so I can reflect a little more. I’m also trying to reboot my daily meditations, which I’ve been doing for the better part of ten years now.

Q: What were you seeing in the market that made this the right time to build Pearl Health?

My time at Oscar showed me how under-appreciated and under-equipped primary care is in healthcare delivery. As our population demographics shift toward more Medicare enrollment and rising medical costs, our founders and early team knew we were at an inflection point of healthcare sustainability and access. When I learned of new, innovative models out of the Centers for Medicare & Medicaid Innovation, I felt we were on the precipice of a huge idea that was going to make a national impact. The opportunity to bring a renaissance to primary care and through true technology enablement and contribute to more affordable Medicare and better health outcomes for our seniors was a clear need — and addressing that need has been our mission since day one.

Q: Were there any specific insights from your time at Oscar that helped you during the early stages of building Pearl Health?

I was fortunate enough to join Oscar early and helped it build from a small pre-revenue private company to a large publicly-traded one. My team was responsible for distributing Oscar’s health plans across the country, then building complete networks to serve them. Ultimately, I managed Oscar’s largest P&L — greater than $2.5B — to help make Oscar more sustainable. Beyond the operational lessons learned from scaling an early-stage startup all the way to IPO, the experience also gave me deep insight into our healthcare system.

For me, Oscar reaffirmed the critical lesson that incentives matter — and, more specifically, that we have deeply misaligned incentives in our healthcare system that devalue primary care. This insight hinted at a huge opportunity, which ultimately manifested itself in the mission of Pearl Health.


Q: Did/do you have a mentor, and how were they most helpful?

I do. George David, current Chairman of Raytheon, has been my mentor for almost 20 years. We meet twice a year, typically at his home in the city. He’s a deep systems thinker, a fantastic communicator, and has managed 300,000 people and built $100B+ of enterprise value. He’s my better in so many ways, and I’ve been blessed to absorb his lessons over the years; he’s kind and willing to push me to be my best. I don’t make big decisions without consulting him.

Q: Was there an unexpected piece of advice, or something you heard or read that has stuck with you or reframed your thinking as you’ve grown as an entrepreneur?

I think the most impact has come from Ray Dalio. His obsession with culture has had a lasting imprint on me. Meaningful work and long-term relationships were a big mantra of his, and while the start-up world tends to focus on rapid hiring and big ideas, I think the intentionality of doing something important with people you want to work a long time with is a winning formula.


Q: How did you convince your early investors to partner with Pearl Health during the company’s early days?

A: Pearl was born from an incubated concept, so when we first started by joining the company we were quickly funded by Kevin Ryan and AlleyCorp. Our Series A was a product of a great team in a critical and rapidly growing space. We had numerous investors interested at that point as TAM and Team were significant.

Q: Why did you choose to partner with SV Angel? What is it like to work with the SVA team?

A: I met Ashvin Bachireddy from an introduction from a16z, and I was impressed by SV Angel’s questions, their decisiveness, and how they interacted with us. In truth, we hadn’t spent a ton of time, but somewhat like my feelings about a16z I had an instinctual sense they were different from everyone else, and they were special. At every interaction along the way that instinct has been confirmed.

Team & Culture

Q: Can you share any valuable lessons about recruiting and scaling a world-class team?

A: I think I still have a lot to learn so am fairly humble about what I know.

I try hard to hire people for their long-term potential, not just their knowledge of a role or their fit in a moment of time. I care a lot about culture. I think that matters more than intelligence.

From a recruiting perspective, I think you can hire fast or well (rarely both). I’d rather hire well. Then, once people join the team, you want to create an environment of continuous development and growth. To do that, people need to be open and tolerant of feedback. That goes for me too. We only get better if we continuously evolve; none of us are born great. It’s critical to have an environment where people feel they can give and receive feedback.

Q: How would you describe the culture at Pearl Health to a prospective hire?

I like how Marc Andreessen thinks of this, and I tell people culture is what everyone says it is at any given moment. In that sense, it’s a continuous referendum on Pearl. I don’t think culture is set from the top down though it certainly has a strong influence. What we’re trying to do is have a place where every person is helping us drive the company and in that way are each defining what Pearl is: so you’d have to ask them and keep me honest. My answer would be that we’re an intelligent, intense, and dedicated group of people trying to solve a very important problem. We work hard on that problem, but we’re also a really fun and funny group of people. I’m not funny but, knowing that, I really try to create a space where people can be funny and I really enjoy that.

Q: What will Pearl Health look like ten years from now?

We’ll be a technology layer running over tens of billions of dollars of healthcare expenditures that is consistently lowering the cost of healthcare and improving access to needed care for patients. That platform will supply intelligence to providers to make great decisions for what patients need and leverage their capabilities, so that smart and cost-effective care is automatically delivered to the right people at the right time.

Q: What does “success” mean to you and the company?

We want to delight physicians and enrich them so they can deliver excellent care to Medicare patients and beyond while also lowering the cost of that care for them and for our country. As we succeed in that we can look to other lines of business.


Q: What are you reading, listening to, or watching for inspiration right now?

I’m listening to Power Failure currently or I start my day with The Weekend.

Q: Quotes you live by?

We will either find a way or make one.