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Mednax Inc, a U.S. healthcare network operator targeted by activist hedge fund Elliott Management Corp, is fielding acquisition interest from several private equity firms, according to people familiar with the matter.

Elliott disclosed a 7 percent stake in Mednax last month and said it would discuss several options to boost value for shareholders, including a sale of the company.

Mednax is working with Bank of America Corp to handle the approaches by Carlyle Group LP and other private equity firms, the sources said this week.

Mednax has not yet started the process of selling itself, and there is no certainty any deal will occur, the sources added, requesting anonymity because the discussions are confidential.

“We have not hired an adviser with regards to approaches by private equity firms,” a Mednax spokesman said.

He would not say whether such overtures had occurred or whether the company had retained Bank of America in any capacity. He also declined to elaborate on the company’s plans.

Bank of America and Carlyle declined to comment.

Mednax shares rose as much at 5 percent on the news but were up only 1.2 percent at $50.40 by the afternoon. At that price, the company’s market capitalization was around $4.66 billion.

A deal for Mednax would be the latest in a string of acquisitions of physician networks, a business that has struggled in recent years to adapt to changes in how U.S. health insurers reimburse providers.

Federal reimbursement programs such as Medicare and Medicaid, for example, have been trying to shift to a “value-based” payment model, where providers sometimes receive fixed payments to encourage them to control costs.

Last week, Reuters reported that kidney care provider DaVita Inc was exploring a potential sale of its own physician network business, DaVita Medical Group, for up to $4 billion.

Earlier in November, another physician services provider, Envision Healthcare Corp, announced plans to explore strategic alternatives. Previously, it had attracted investments from activist hedge funds Starboard Value and Corvex Management.

Last year, Blackstone Group LP acquired hospital staffing provider Team Health Holdings Inc for $6.1 billion.
Fort Lauderdale, Florida-based Mednax provides neonatal and radiology services through a network of more than 4,075 physicians in all 50 states and Puerto Rico. Its nine-month earnings before interest, taxes, depreciation and amortization have declined to $431 million at the end of September from $493 million a year earlier.

In response, Mednax has announced a series of efforts to boost profits, including a new focus on radiology and a long-term goal to slash general and administrative expenses by around 10 percent.