Fresenius SE & Co. KGaA (XTRA:FRE) is exploring a potential combination of its Helios unit with a rival hospital chain after fielding interest from large buyout funds, people familiar with the matter said. Fresenius is leaning toward the option of merging Helios with a competitor, rather than selling a minority stake in the business in return for cash, the people said.

It has held initial talks with private equity firms including CVC Capital Partners Limited and KKR & Co. Inc. (NYSE:KKR)  about possible transactions, the people said, asking not to be identified because the information is private. A deal could value Helios at around €20 billion ($21 billion) including debt, the people said.

Fresenius is preparing to carve out Helios as a standalone unit ahead of any future transaction, the people said. The unit will remain part of Fresenius, Chief Executive Officer Stephan Sturm told Helios workers on June 28, 2022 at an annual staff meeting, according to a person who was present. Sturm said every activity to bring an equity partner on board will be connected with a concrete growth step, and Fresenius plans to maintain a majority stake, the person said, asking not to be identified discussing an internal meeting.

Sturm is under pressure to reignite growth, having seen shares of Fresenius lose roughly half their value since 2017. Deliberations are ongoing, and Fresenius continues to study a number of options for the business, the people said. Representatives for Fresenius and for CVC declined to comment, while a spokesperson for KKR didn't immediately respond to a request for comment.