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.
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
Change in Vendors
OHA recently concluded a competitive procurement process and has selected Human Services Research Institute (HSRI) as the new vendor to collect and maintain APAC data. The transition will occur in late 2020 with HSRI's first data collection occurring in January 2021. This transition will:
Save money. The five year total cost, including the cost of implementing the new solution, saves almost $200,000 per year.
Improve transparency. Any data enhancement specific to HSRI or Oregon will be fully transparent on the method of calculating the field, while data elements based on third party algorithms, such as HEDIS and AHRQ measures, will maintain their current level of transparency.
Help researchers. Moving from a business perspective focused on present-day data to a research perspective that supports longitudinal studies will enhance the use of APAC data to track regional cost and utilization trends over time.
High-Level Vendor Transition Schedule
(last updated 3/2/2021)
System Design|| ||Complete|
System Security|| ||Complete|
Data Submission|| || Complete|
Data Access/Use|| || |
||Data Dictionary available||Available Mar. 15 2021|
||Data Elements Workbook for Limited data sets (APAC-3) forms available||Available Mar. 19 2021|
||Data Migration completed; 2020 Q4 data (submitted January 31, 2021) available in production analytic views||Mid-Apr. 2021|
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.
Current and new data submitters can find information about submission specifications, schedules, and waivers below.
APAC-1: Waiver or Exception of Reporting Requirements (please open with a PDF reader to see signature fields)
Use this form to request an exception to mandated reporting requirements.
Administrative Rule (OAR 409-025-0100 to 409-025-0190, filed 5-30-19)
Appendices A-G and 1 & 2, Version 2020.0.0
Data Submission Schedule, 1-31-2019 to 1-31-2022
APAC Submission Memo for Version 2020.0.0
FAQs for Version 2020.0.0
Payment Arrangement File: Technical Assistance for CCOs (2020)
2021 Oregon Mandatory Reporters and Abbreviations