APAC Data Requests

Welcome

The All Payer All Claims (APAC) program provides data to Oregon state agencies and external requestors for research, public health activities, health care operations, and work conducted on behalf of the Oregon Health Authority (OHA).

The application and request process for APAC data depends on both the requested data type and the requester’s role. We encourage those interested in using APAC data to review the APAC Overview for more information about APAC’s data request process.

All APAC data requests must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Oregon Administrative Rule (OAR) 409-025-0160. As part of the application and review process, requesters must demonstrate:

Appropriate and approved use of the data
That only the minimum necessary data is requested
Compliance with HIPAA standards for data use, storage, privacy, and security.

A consultation meeting with the APAC team is required before submitting a request. To schedule a meeting, please email us at APAC.Admin@odhsoha.oregon.gov.

APAC Data Releases

APAC claims data is released on a two-year delay from the initial submission deadline, allowing time for a full calendar year of claims data to be complete and reliable. Refer to the table below for the schedule of upcoming calendar year (CY) data releases.

For more information on our data submission and release deadlines, please see the APAC Frequently Asked Questions (FAQs).

Data	Release Date
CY 2024 claims	January 2026
CY 2025 claims	January 2027
CY 2026 claims	January 2028

What Data is in APAC:

2011-2024 Medical, Pharmacy and Dental Claims Data

Claim status (paid, denied)
Line of business (commercial, Medicaid, Medicare Advantage)
Payment information from insurers and patients
Clinical coding

Diagnosis and procedure codes
Bill type, place of service, revenue codes

Member Enrollment and Demographic Information

Monthly member enrollment data
Member Demographics

Sex, age, race, and ethnicity

Provider Information

Provider identifiers, locations, and specialties

Provider-level Alternative Payment Methodologies

See our Payment Arrangement Dashboard for more information

What Data is Not in APAC:

Clinical or electronic health record (EHR) data
Prescribed pharmaceuticals (only dispensed)
Pharmaceutical rebates
Data from commercial insurers or TPAs with less than 5,000 covered lives in Oregon
Federal Programs (Veterans Affairs (VA), Indian Health Services, etc.)
ERISA-based or self-insured employers that are exempt from APAC reporting
Uninsured and self-pay claims

APAC Data Not Available for Request*:

CMS- reported Fee-For-Service Medicare claims data (Medicare Advantage claims are available)
Names of commercial payers and identifiers in combination with amount paid, allowed, or billed
Billed premium data
Medicaid-only data (request directly through the Health Analytics data request form)
Direct patient identifiers (names, addresses, date of birth)

This list is not exhaustive. If you have questions, we encourage you to review the APAC Data User Guide and schedule a consultation meeting with our team. To schedule a consultation meeting, email the APAC admin inbox at APAC.Admin@odhsoha.oregon.gov.

*For Oregon state agency partners and public health agencies responsible for public health surveillance that are interested in requesting APAC data, please reach out to the APAC admin inbox at APAC.Admin@odhsoha.oregon.gov for more information about agency and/or public health surveillance request details.

Request Types

Limited Data Sets

Customized data sets that may contain identifiers
Must adhere to HIPAA minimum necessary requirements
Require a Data Use Agreement (DUA)
Request purpose must be:

Research- requires IRB approval or exemption
Public Health Activities- conducted by a public health authority for surveillance, investigation, or intervention
Health Care Operations- Supports activities of a HIPAA-covered entity

OHA Business Associate- work done on behalf of OHA by a contractor or vendor

Agency Requests

Requests made by or on behalf of state agencies
Requires a Data Use Agreement (DUA) or Memorandum of Agreement (MOA)
Requests must be initiated by an Oregon state agency (OHA, ODHS, DCBS, etc.)
Request purpose must be:

Work done on behalf of OHA

APAC Data Request Process

APAC Limited Data Set requests typically take 6-8 months to fulfill. This timeline may be extended due to delays in obtaining all necessary DUA signatures and approvals.

APAC Agency requests typically take 2-3 months to fulfill, depending on the complexity of the request and the level of effort required from APAC Research Analysts.

Requests for APAC Limited Data Sets are evaluated by OHA's Data Review Committee to ensure the proposed project scope complies with OHA policies and state and federal laws. Learn about this committee on the Data Review Committee webpage.

For more information and an outline of the APAC data request process, please see below.

1. Consultation Phase

The APAC team meets with prospective data requesters to determine if APAC data is a good fit and can meet the data needs and timeline.
APAC helps identify the appropriate application type and data needs

2. Application Phase

The requester works with the APAC team to complete and submit the application.
The APAC team assigns an APAC Research Analyst (RA) to the request, and the RA works with the data requester for additional information and clarification about the project and the data needed.

3. Administration Phase

Once the application and materials have been finalized, the RA submits the materials to the Data Review Committee (DRC).
The materials are posted for two weeks before DRC review.
If approved, the APAC team issues an invoice and DUA to the requester.

Note: Agency requests are placed on the DRC's agenda as a consent item. This means the committee is informed of the request but does not vote on it. These items are acknowledged without discussion unless a committee member requests otherwise. Agency requests are also not held to the two-week posting period and can proceed without delay.

4. Dataset Construction Phase

Once all DUA signatures and invoice payment is received, the RA codes and builds the dataset.
A peer RA may review the query code
APAC's data vendor, HSRI, builds the data file and prepares the data for secure transfer to the data requester via email.

Limited Data Set Application Forms

For external applicants

APAC Limited Data Set Application (APAC-3) (Word)

Required Application for an APAC Limited Data Set

Data Elements Workbook (Excel)

A required workbook where requestors select and justify the data elements they need for their research project.

Data Security Plan (Word)

Required document describing how you/your organization will protect APAC data.

IRB Application

Include the full application.

IRB Determination

Must include IRB determination.

IRB Approve Research Protocol

Please include this description of your research methodology in a separate document even if the methodology is clearly stated in the IRB Application.

Agency Request Application Forms

For internal state agency applicants

Agency Application (PDF)

For use by Oregon state agencies requesting APAC data.

Data Elements Workbook (Excel)

A required workbook where requestors select and justify the data elements they need for their research project.

Additional Forms

These forms may be required after a request has been approved

Amendment Application
Use this form to request changes to an approved APAC data request, such as adding data, modifying the data use, or updating the research protocol.

Note: No changes are authorized until the amendment is reviewed and approved.

Staff Amendment Application
Use this form to update the staff listed on an approved APAC data request. This form is only used for personnel changes.

Cost Waiver Request Form

Optional form to request a waiver for some or all costs associated with an APAC Limited Data Set request.

Renewal Application
Submit this form to extend the Data Use Agreement (DUA) or provide updated IRB approval. If your IRB approval will expire within 60 days of submitting this form, please include the updated IRB documentation.

Reminder: if the DUA or IRB approval (if required) has expired, all project activity must stop and APAC data must be destroyed. 

We strongly recommend talking with the APAC Team prior to submitting a data request. To request a meeting, please email us at APAC.Admin@odhsoha.oregon.gov

The APAC team recommends that data requesters review the following documents to understand which data are available in APAC, potential uses and limitations, and the APAC data request process.

APAC Data Request Overview

Provides an overview of the APAC data request process, including what data are collected and released.

APAC Data Profile

Provides a basic description about the APAC program and data.

APAC FAQs

Answers commonly asked questions about data collection, management, access and use.

APAC Data User Guide
A more in-depth resource with release notes, data limitations, business rules and other tips for interpreting APAC data correctly.

APAC Data User Guide Counts

An Excel document with detailed summary data including counts and crosstabulations. This workbook is linked to the Data User Guide.

APAC File Layouts

File layouts used by APAC data submitters to submit data to APAC.

APAC Use Cases
Showcases previous projects for which APAC data have been approved and used.

APAC Model Application

This is a real APAC-3 Limited Data Set Application that shows the specificity and level of detail needed from data requesters in order to have their data set application approved.

Guidance for Students Interested in APAC Data

Includes considerations for students interested in using APAC data.

OHA encourages the use of data for research and healthcare operations. However, external requesters of APAC data must cover the actual costs associated with fulfilling their data requests.

APAC does not use a flat rate based on year or file type. Instead, costs are based on the amount of time and administrative effort required to fulfil each request. Requesters are required to request only the minimum necessary data to answer their research questions, in accordance with HIPAA requirements.

Multi-year requests are only approved if:

The project involves longitudinal analysis, or
The condition studied is rare, resulting in a small number of claims in a single year

How Costs Are Determined

The total cost includes:

Staff time for research and administrative activities (a per-hour rate)
A standard vendor fee of $890 to build, validate, and securely transfer the data

Payment is required before data files are created and transferred. In most cases, the total cost, including the vendor fee, for an APAC limited data set file is around $3,500, assuming no additional processing or linking is required.

Special Processing Costs

Additional charges apply for special processing such as:

Matching to an external file
Running RAND's Bayesian Improved Surname Geocoding (BISG)

These services are billed at the data vendor's rate. APAC does not release names or street addresses for matching. If matching by names is required, the requester must provide a finder file. Matching by the data vendor using a finder file incurs and additional cost of $3,800.

Cost Waivers

If standard fees are a barrier, requesters may submit an APAC Cost Waiver Request. The APAC team reviews cost waivers and makes a determination based on the requester's existing funding and the complexity of the data request. Please note:

Approved waivers only apply to direct APAC staff costs
Vendor-related costs are not eligible for a cost waiver.

APAC partners with the Center for Health Statistics (CHS) to offer data linkage between APAC and birth and/or death certificate data. Data linkage between APAC and birth and/or death certificate data offers a number of advantages to APAC requestors:

For APAC requestors interested in patient mortality rates, status and cause of death, Oregon death certificate data is a rich source of information. Without death certificate linkage, it is difficult to have a complete picture of whether and when an individual with data in APAC may have passed away.
Linkage to birth certificate data can help identify parent/child relationships in APAC data; birth certificate data also contains detailed information on mother and child health status.

Due to APAC/CHS coordination, researchers do not need to request identifiable information necessary for linking the datasets themselves (name, date of birth, etc.), ensuring better data security and protection of sensitive information. The partnership also shortens the amount of time needed for APAC to review requests involving both data sets.

In order to request APAC-CHS data linkage, requestors must be approved for data release separately by both APAC and CHS. If approved, APAC will provide a crosswalk linking APAC's unique person ID to the deceased (death certificate data), or to mother/first parent, father/second parent and child (birth certificate data).

Note that the linkage is not a 'complete' one; not all individuals in CHS data are present in APAC, or present at the time of the birth or death in question. Additionally, there are some individuals in APAC who cannot be linked to CHS data with certainty based on the information (name, date of birth, etc.) available in each respective dataset.

To request APAC data with a linked vital (birth and/or death) records file:

1. Complete an APAC-3 application for a limited data set and the Data Elements Workbook.

Indicate in the APAC-3 Project Methodology and Analytic Plan (Section 2, Question 4) that you are requesting linked vital records data. Describe which variables you intend to request from CHS, noting specifically if you are requesting demographic variables including date of birth, address, county, zip code or other potentially personally identifiable information.
For research requests, indicate on the Institutional Review Board application that linked vital records-APAC data will be used.

2. After receiving notice of approval for APAC data, apply to the Center for Health Statistics (CHS) for vital records data, noting that you are requesting data linked to APAC in your application. Include the notice of approval from APAC with your signature documentation (the final step in submitting a request for Vital Statistics data, after filling out the application). After CHS reviews your application, CHS will notify APAC of approval or disapproval of your request.

3. When you receive your APAC data, the APAC team will provide a crosswalk of unique person identifiers in APAC to identifiers in CHS. CHS will transfer their data to you separately from your APAC data release.

Contact

Email the APAC team: APAC.Admin@odhsoha.oregon.gov.

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