NEW YORK — SEPTEMBER 1, 2026 — As states look for ways to strengthen primary care while controlling health care costs, a new report from Primary Care Development Corporation (PCDC) finds that All-Payer Claims Databases (APCDs) can be powerful tools for measuring and advancing primary care investment policy — but only when states make the data accessible, transparent, and directly relevant to their policy goals.

The report, “All Payer Claims Databases & Primary Care Investment,” examines how states across the country are using APCDs, which collect health care claims and payment information from multiple public and private payers. The analysis outlines lessons for policymakers seeking to understand how much their states invest in primary care and develop policies to strengthen it.

“Strong primary care is essential to a health care system that keeps people healthier and communities stronger,” said Aparna Mekala, PCDC Chief Executive Officer. “States need practical tools to understand where health care dollars are going and whether enough is reaching primary care. This report provides policymakers with lessons from across the country that can help them turn data into action — while making clear that the absence of perfect data should never be a reason to delay progress.”

Primary care accounts for approximately 35% of all health care visits but only 5% to 7% of health care expenditures, according to research cited in the report. States increasingly are exploring policies to increase primary care investment, creating a growing need for reliable data to measure spending and assess progress.

“States across the country are asking how they can better measure primary care investment and use that information to improve their health care systems,” said Aamir Mansoor, PCDC’s Director of Policy and co-author of the report. “Our research shows that APCDs can be extremely valuable, but simply collecting data isn’t enough. States need to make that information usable and connect it to clear policy goals. Just as importantly, states without an APCD should not wait to act – there are other ways to measure primary care spending and begin strengthening investment now.”

The report highlights several states’ approaches to primary care investment. Oregon, for example, uses claims and non-claims payment data to track progress toward its primary care investment goals. Colorado collects information on alternative payment arrangements, helping capture primary care investments that may not appear in traditional claims. Washington pairs its APCD with a public-facing tool designed to make complex health care data more accessible.

The analysis also identifies significant limitations. Nearly half of the U.S. population lives in states without an APCD. Even where databases exist, their usefulness can sometimes be constrained by gaps in data, restricted access, reporting lags, insufficient funding, and the failure to capture payments made outside traditional fee-for-service claims.

The latter issue becomes especially important as health care increasingly moves toward value-based payment. Payments for services such as care coordination, capitation, performance incentives, and shared savings may not appear in traditional claims data, potentially causing states to undercount how much is actually being invested in primary care.

Based on its analysis, PCDC recommends that states prioritize transparency and usability; align APCDs with primary care spending targets and broader policy goals; incorporate non-claims payments; establish sustainable funding and governance; and pursue alternative reporting approaches when an APCD is not available.

The report was informed by members of the Primary Care Investment Network (PCIN), a PCDC-convened national network of state-level primary care investment policy experts, advocates, researchers, and implementation leaders. PCIN connects leaders across states actively pursuing primary investment policy to share policy experiences, implementation lessons, and approaches that can be adapted to different health care and political environments.

The report was authored by Mansoor and Joe Telano, PCDC Assistant Director of Policy, with contributions from Julie Schilz, PCDC Senior Director of Consulting & Training, and informed by state policymakers and other experts participating in PCIN. The work was made possible by funding from the Commonwealth Fund and support from the Milbank Memorial Fund.

Read the report: https://www.pcdc.org/wp-content/uploads/PCDC-APCD-PC-Investment-Report-August-2026.pdf

Register for PCDC’s webinar about the findings: https://pcdc.zoom.us/webinar/register/WN_lt4oaMj5ScG1Tp5YtkMIVQ#/registration

About Primary Care Development Corporation

Primary Care Development Corporation (PCDC) is a national nonprofit organization dedicated to strengthening primary care and advancing health equity through capital investment, expertise and advocacy. Learn more at pcdc.org.

Media Contact:
Barbara Rosen
barbara@anatgerstein.com