KKR is adding to its healthcare portfolio by acquiring physician services provider Envision Healthcare for $5.57 billion in one of the largest private equity buyouts since the financial crisis.

The companies on Monday announced a deal that will pay Envision shareholders $46 per share — a premium of 5.4% to the closing price on Friday — and, including assumption of debt, is valued at about $9.9 billion.

Envision had reached out to 25 potential suitors as part of a strategic review that began after it posted disappointing third-quarter results last year. KKR already owns Envision’s ambulance unit AMR, which it bought for $2.4 billion last year and merged with its helicopter ambulance service.

“After conducting a robust review of the business and competitive landscape, the company’s opportunities and challenges, and the strategic and financial alternatives available to the company, the board unanimously believes that this transaction will deliver the most value to Envision’s shareholders,” James D. Shelton, Envision’s lead independent director, said in a news release.

As Reuters reports, the deal “is the latest in a spate of mergers and acquisitions among physician networks, a business that has struggled in recent years to adapt to changes in how U.S. health insurers reimburse providers.”

As of March 31, 2018, Envision provided physician services, anesthesiology services, radiology/tele-radiology services, and children’s services to more than 1,800 clinical departments in healthcare facilities in 45 states and the District of Columbia.

KKR’s healthcare assets also include WebMD Health Corp., which it took private for about $2.8 billion.

“Envision is a leading provider of physician-led services in a health care system in which physician-patient interactions have a pronounced impact on nearly all health care decisions,” said Jim Momtazee, head of KKR’s healthcare investment team.

Private equity firms, armed with a record $1 trillion in cash, have been investing more in public companies than at any time since the financial crisis. Take-private deals worldwide reached a decade-high of $109 billion last year, according to data provided to Reuters from industry tracker Preqin.

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