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Some Never Get COVID; Private Equity Targets Nurse Staffing Firms; $13K Donor Bill

— This past week in healthcare investigations

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INVESTIGATIVE ROUNDUP over an image of two people looking at computer screens.

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Some People Will Never Get COVID

Researchers are trying to understand why some people never get COVID-19, even if they've been exposed to the virus, .

In a human challenge trial reported in preprint, 16 of 34 people who were exposed never got infected, according to Axios. On the other hand, some did become sick after a very small dose -- raising questions about why some people are more vulnerable than others.

Axios reported that researchers are investigating four main theories: 1) cross-protective immunity from previous infection with the four endemic human coronaviruses; 2) genetic variation that makes the immune system more or less susceptible to the virus; 3) the role of strong mucosal immunity; and 4) how the virus entered the body, the size of the dose, or the length of exposure.

Those who've been exposed to the virus but haven't fallen ill have been dubbed the "never COVID" cohort. But Gigi Gronvall, PhD, an immunologist and senior scholar at the Johns Hopkins Center for Health Security in Baltimore, warned that "I hope that people don't think they're superhuman," assuming that they're protected from the virus because they haven't gotten it yet.

Private Equity Goes After Nurse Staffing Agencies

Private equity firms are investing in nurse staffing agencies as demand for healthcare workers has turned them into a lucrative business, .

Since the beginning of 2021, more than half a dozen private equity firms have bought at least seven staffing agencies, according to a STAT analysis of public announcements.

Two firms -- Leonard Green & Partners and Ares Management -- have had long-standing investments in these agencies. But six others -- Periscope Equity, Cornell Capital, Trilantic North America, Centerbridge Partners, Littlejohn & Co., and MidOcean Partners -- have joined them since the start of 2021.

Medical Solutions and Favorite Healthcare are the largest staffing firms owned by private equity, STAT reported. Medical Solutions was purchased by two private equity firms in August, and Favorite Healthcare was acquired by a private equity-owned staffing firm in January.

AMN Healthcare and Cross Country Healthcare are two other major staffing firms, and while they aren't owned by private equity, they still have substantial ties to Wall Street, STAT reported. "Their largest institutional investor is BlackRock, which is run by private equity titan Larry Fink, and both companies have at least one board member affiliated with private equity," the report states.

Nurse staffing agencies have come under scrutiny by members of Congress for their pricing practices during the pandemic. Earlier this month, some 200 members sent a letter to White House COVID-19 Response Team Coordinator Jeffrey Zients asking the Biden administration to investigate possible price gouging at the agencies.

Kidney Donor Incorrectly Billed $13K

A kidney donor was hit with a bill for more than $13,000 that he should never have received, .

Last July, Elliot Malin donated his kidney to his cousin, Scott Kline, and was assured by the hospital that he wouldn't pay a penny of the $160,000 estimated cost of the procedure, as Kline's insurance would cover all of Malin's medical costs. In general, living organ donors aren't supposed to be billed for transplant-related care, ProPublica reported.

The surgery happened in July at Baylor Scott & White All Saints Medical Center in Fort Worth, Texas. Everything went fine -- until late September, when Malin received a bill for $13,064 from NorthStar Anesthesia. He ignored it, knowing his costs were covered, until he received a second and so-called "final" notice a month later, warning that the bill would be sent to collections.

Malin called the billing company and the hospital and waited, but didn't hear anything until January 19 -- a day after ProPublica had reached out to NorthStar for comment.

The company told Malin via email that it had received incorrect insurance information, but a spokesperson later told ProPublica it received no insurance information at the time of the surgery -- and in those cases, bills are automatically sent to the patient.

"To be clear, it is not NorthStar's policy to bill transplant donors for bills related to their donation surgeries," the spokesperson wrote to the news agency. "We recognize the well-established public policy standard and practice that transplant donors should not be billed for such services -- that we and the nation's health care system have a responsibility to foster and encourage such acts of selflessness and generosity."

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    Kristina Fiore leads MedPage’s enterprise & investigative reporting team. She’s been a medical journalist for more than a decade and her work has been recognized by Barlett & Steele, AHCJ, SABEW, and others. Send story tips to k.fiore@medpagetoday.com.