In this May 12, 2014, file photo, Paul Singer, founder and CEO of hedge fund Elliott Management Corporation, speaks at the Manhattan Institute for Policy Research Alexander Hamilton Award Dinner in New York. Prominent athenahealth investor Elliott Management Corp. is offering about $6.5 billion to take the medical billing software maker private after saying it has grown frustrated with the company's performance. Shares of athenahealth soared early Monday, May 7, 2018, after the shareholder outlined its proposal. Credit: John Minchillo | AP

The activist hedge fund that pushed digital health care giant athenahealth to lay off 500 workers scattered across the country last year has made a $6.9 billion offer to purchase the company.

Elliott Management, an activist hedge fund that buys large stakes in big companies in an effort to influence their business and management, offered to buy the Massachusetts-based company for $160 per share on Monday.

Athenahealth said its board of directors would “carefully review the proposal to determine the course of action that it believes is in the best interest of the company and athenahealth shareholders.”

Elliott Management, headed by billionaire Paul Singer, has been critical of athenahealth’s operations since it bought 9.2 percent of the company in May 2017. About three months later, athenahealth said it would review its operational and financial strategy, leadership and governance to save $100 million to $115 million by the end of 2018.

It announced the layoffs in October 2017.

A small percentage of those cuts were made in Belfast, though the company continued to hire people in Belfast for other positions and its workforce numbers quickly recovered. The company has declined to provide a breakdown of how many employees were laid off from specific locations.

In a letter announcing the offer, Elliott Management said that athenahealth’s stock is underperforming and that, for shareholders, “owning athenahealth has been a disappointing experience.”

“Given athenahealth’s potential, this reality is deeply frustrating,” the letter states, “but the fact remains that athenahealth as a public company has not made the changes necessary to enable it to grow as it should and to create the kind of value its shareholders deserve.”

Athenahealth employs about 950 people in Belfast, where it operates a call center, medical billing operations and more. Officials at the Belfast site have said they hope to expand to 1,200 workers in coming months and years. That would account for about one-fifth of the company’s total workforce.

Elliott Management has yet to reveal what changes might result if athenahealth accepts the buyout.

Follow Nick McCrea on Twitter at @nmccrea213.

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