All Payer All Claims Reporting Program

Welcome

The Oregon All Payer All Claims Reporting Program (APAC) has been integral to Oregon's health system transformation since it was established in 2009. It contains administrative health care data on topics such as insurance coverage, health service cost and utilization for Oregon's insured populations. APAC provides access to timely and reliable data essential to assess the cost of health care, improve quality, reduce costs and promote transparency.

The purposes of APAC are described in statute (ORS 442.373) and include:

Allowing health care policymakers to make informed choices
Improving the quality and affordability of health care and health care coverage
Comparing the costs and effectiveness of treatment settings and approaches
Providing information to consumers and purchasers of health care

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)

*Estimating the Number of Individuals with ERISA Self-Insured Coverage Who are Missing from APAC – 2018 Data

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.

Read the APAC Overview to learn about 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.

Addtional Resources:

Read the APAC Data profile to learn the basics the database
Frequently Asked Questions document answers questions about APAC data collection, management, access and use.
Insurance Claims 101

For information about how to use APAC data, the data request process, and applications, visit our APAC Data Request Page.

For information about how to submit APAC data, the data submission process, and submission requirements, visit our APAC Data Submission page.

Payment Arrangement File

Oregon Health Care Payment Arrangements in 2022 (Published in June 2024) – How did Oregon's Coordinated Care Organizations (CCOs) and other health care payers pay for health care in 2022? The report also shows trends in value-based payment implementation since 2019.
Oregon's Health Care Payment Arrangements in 2021 (published May 2023) – How did Oregon's Coordinated Care Organizations (CCOs) and other health care carriers pay for health care in 2021?
Oregon’s Health Care Payment Arrangements in 2020 (published June 2022) – How did Oregon's health insurance carriers and Coordinated Care Organizations (CCOs) pay for health care in 2020?
Oregon’s Health Care Payment Arrangements in 2019 (published Sept. 2021)
October 2020 Data Brief: How Oregon's Insurance Carriers and Coordinated Care Organizations Paid for Health Care in 2018.

Primary Care Spending in Oregon

Senate Bill 231 (Oregon Law 2015) required the Oregon Health Authority and the Department of Consumer and Business Services to report on the percentage of medical spending allocated to primary care carriers, PEBB, OEBB and Coordinated Care Organizations (CCOs).