About APAC
APAC receives administrative data on most Oregon residents. Administrative data are collected by insurers for purposes related to issuing coverage and making payments.
As an example, for 2018, APAC contains data representing 92% of Oregon residents despite lacking some self-insured data. Those not in APAC are uninsured, are covered by Federal programs such as Tricare or Veterans Affairs or are covered by self-insured plans not reporting to APAC. In 2018, APAC contains:
- ~100% of fully-insured (1,837,000 members)
- 36% - 61% of self-insured (318,000 - 534,000 members)*
- 96% of Medicaid OHP/CCO and FFS (1,219,000 members)
- ~100% of Medicare (966,000 members)
APAC receives medical claims, dental claims, pharmacy claims, payment amounts, member demographics, billed premiums and provider information. Data are received from insurance companies, third party administrators and pharmacy benefits managers identified as mandatory reporters.
APAC Overview
Provides an overview of the APAC database, including its purpose, what data are collected, how data are used, and the data request process.
How are APAC data used?
- APAC has been used by OHA, other state agencies, researchers and organizations working to improve health care. A few examples include:
- OHA has used the information to review rates paid to coordinated care organizations.
- APAC data are one source used to compare Medicaid payments to commercial and Medicaid costs. The Department of Consumer and Business Services did a similar comparison for workers' compensation payments.
- Oregon State University used APAC data to determine the economic impact of having athletic trainers in high schools. The study found health benefits beyond specific sports applications. Published in
Injury Epidemiology 2019.
- To see more examples of APAC data use, see our
APAC Use Case document.
Frequently Asked Questions
Answers questions about APAC data collection, management, access and use.
Insurance Claims 101
For Data Requesters
For information about how to use APAC data, the data request process, and applications, visit our
APAC Data Request Page.
For Data Submitters
For information about how to submit APAC data, the data submission process, and submission requirements, visit our
APAC Data Submission Page.
APAC
Current and new data submitters can find information about submission specifications, schedules, and waivers on the
APAC Data Submission Page.
Primary Care Alternative Payment Methods - Contract Reporting
Please refer to the
Primary Care Payments page for more information.
Reports
Payment Arrangement File
Leading Indicators for Oregon's Health Care Transformation
This report presents quarterly data from Oregon's All-Payer All Claims Reporting Program.
Additional Resources
Oregon Revised Statute (ORS 442.372, 442.373, & 442.993)
Statute that mandates reporting of health care claims data.
Oregon Administrative Rules for APAC (OAR 409-025)