Kate Rooney | CNBC

Jonathan Bush, co-founder, Chief Executive Officer, and President of Athenahealth.

Bush could come under fire as the conversations progress. He is known for being outspoken and at times, controversial. And Elliott has taken aim at management in some of its recent investments, recently calling for the ouster of Arconic’s Klaus Kleinfeld, who resigned after sending a threatening letter to Singer without board approval. The firm is also headed to court on Monday in the Netherlands to seek means for removing Anthony Burgmans , the chairman of Akzo Nobel, which has rebuffed several takeover offers from Pittsburgh-based PPG Industries. Elliott holds a stake in the Dutch paint maker.

The firm also has a strong track record for helping push companies to be sold. In the last seven years, Elliott has engaged in 38 campaigns, of which 20 have been sold, according to data compiled by Bloomberg, cited by an Evercore analyst.

Elliott is also different from other hedge funds in that it has a private equity arm known as Evergren Coast Capital Corp. The private-equity unit, agreed to purchase Dell’s software unit last year with Francisco Partners Management. That gives the firm more flexibility to ultimately buy companies outright if it so chooses.

At the moment, Athenahealth plans to engage with Elliott.

“We are aware of Elliot’s filing and look forward to talking with them to hear their views about the Company and discuss the actions we are taking to drive enhanced growth and value creation for all athenahealth shareholders,” the company said. “We have great confidence in the Company and where we are headed.”

Athenahealth three-year performance

–With reporting by Meg Tirrell and Bertha Coombs

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