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LIST OF FIGURES

II.1: Overview of Key Relationships in TTW

II.2: Relationships Among Beneficiaries and the Three Types of TTW Organizations

II.3: Ticket Process from Beneficiary Perspective

III.1: Number of Tickets Accepted by Individual ENs, Phase 1 and 2 States (as of July 25, 2003) - Consists of two bar charts showing the number of Tickets accepted by individual ENs in Phase 1 and 2 states as of July 25, 2003. There is a graph for each phase. One-hundred thirty-one ENs were operating in Phase 1 states, and 152 were operating in Phase 2 states. Of the 131 ENs in the Phase 1 states, 30 accepted more than 10 Tickets, 7 accepted more than 50 Tickets, 5 accepted more than 100 Tickets, and just 1 accepted more than 300. Of the 152 ENs operating only in Phase 2 sates, 24 accepted more than 10 Tickets, 2 accepted more than 50, and only 1 accepted more than 100.

III.2: Ticket Holders Generating EN Payments(as of August 8, 2003) - Shows the distribution of Ticket payments by number of ENs as of August 8, 2003. A total of 67 ENs received a payment. Thirty-five of them received a payment for only one Ticket holder, and 60 had received a payment for five or fewer Ticket holders. There is a spike representing the 7 ENs that received more than 5 payments, including 1 EN that had over 30.

III.3: Total Ticket Payment Revenue (as of August 8, 2003) - Shows the distribution of Ticket payment revenue in $5,000 increments from $0 to $40,000 for the 67 ENs that received at least one outcome or milestone payment as of August 8, 2003. Twenty-seven ENs received less than $1,000, and 57 received less than $5,000. There is a sharp spike created by the four ENs that received more than $10,000 each, including one EN that received more than $30,000.

IV.1: Ticket Mailings by Month - Show a stacked bar chart showing Ticket mailings in Phase 1 states by month from February 2002 to August 2003 and in Phase 2 states from November 2002 to August 2003. The mailings in Phase 1 states started in February 2002 with about 240,000 Tickets, dropped to a low of 1,000 in March, rose sharply to approximately 370,000 in April, reached slightly above 615,000 in May, and hit a high of 750,000 in June 2002. By July, however, the number of Phase 1 Ticket mailings dropped to around 150,000 and remained at that level through October 2002. When the Phase 2 rollout started in November 2002, Ticket mailings in the Phase 1 states dropped to around 40,000, falling to about 20,000 in December and remaining at that level through August 2003. In the Phase 2 states, 300,000 Tickets were initially mailed in November 2002, none were mailed in December, but about 300,000 were mailed in January 2003, hovering at or increasing just slightly above that level through August 2003.

IV.2: Cumulative Number of Eligible Beneficiaries Sent Tickets - Shows a stacked bar chart showing the number of beneficiaries in Phase 1 and Phase 2 states who were sent Tickets and remained eligible for benefits, February 2002 through August 2003. The number of eligible beneficiaries in Phase 1 states with Tickets rose from below 300,000 in February 2002 to approximately 2,600,000 in November 2002. The number edged up slowly through August 2003, when it was in the neighborhood of 2,700,000. The number of eligible beneficiaries in Phase 2 states who had received Tickets was slightly more than 300,000 in November 2002 and climbed steadily to about 2,400,000 by August 2003.

IV.3: Ticket Participation by Month - Shows the ticket participation rate by month and by phase from February 2002 through August 2003. This rate is defined as the number of eligible beneficiaries who had assigned a Ticket to a provider and had not subsequently withdrawn it, divided by the total number of eligible beneficiaries who had received Tickets. In Phase 1 states, the participation rate jumped from under .10 percent (one tenth of one percent) in February 2002 to just under .35 percent in March, dropped to just under .25 percent in April, fell to about .20 percent in May, and then rose steadily to over .70 percent by August 2003. In Phase 2 states, the participation rate was below .10 percent in March 2002, rose to .20 percent in April and .35 percent by September, only to drop dramatically to under .05 percent in October, from where it rose steadily to just under .30 percent in August 2003.

IV.4: In-Use Tickets Under the Three Payment Systems - Consists of two stacked bar charts, one for each phase, that compare the percentage of in-use Tickets assigned under each of the three payment systems from February 2002 through August 2003. In Phase 1 states in February 2002, about 70 percent of the Tickets were assigned under the traditional payment system, 5 percent were assigned under the outcome-only system, and 25 percent were assigned under the milestone-outcome system. The percentage of Ticket assigned under the traditional payment system jumped to 82 in March, fell slowly to 77 percent in June 2002, and then climbed steadily to 87 percent in August 2003. The share of Tickets assigned under the outcome-only payment system dropped from 5 percent to 3 percent in August 2002 where it remained unchanged. Under the milestone-outcome payment system, 26 percent of Tickets were assigned in February 2002, dropping to 14 percent in March, recovering slightly to 20 percent by May and then falling steadily to 11 percent by June 2003 where it remained through August of that year. When the rollout began in November 2002 in the Phase 2 states, 72 percent of the Tickets were assigned in under the traditional payment system, 2 percent were assigned under the outcome-only system, and 26 percent were assigned under the milestone-outcome system. The percentage of Ticket assigned under the traditional payment system dropped immediately from its 72 percent starting point in November to 65 percent in December, where it hovered through February until it began to climb continuously to 75 percent in August 2003, just over the original 72 percent at the outset in the previous November. The initial 2 percent of Tickets assigned under the outcome-only payment system in November 2002 rose to 8 percent in December, held steady through January 2003, and settled at 6 percent for the rest of the rollout period. The initial 26 percent of Tickets assigned in November 2002 under the milestone-outcome payment system rose to 30 percent in February 2003 and then fell steadily to its August 2003 level of 20 percent.

IV.5: In-Use Payments Under the Two New Payment Systems - Consists of two clustered bar charts, one for each phase, that compare the number of in-use Tickets assigned under the outcome-only with the number assigned under the milestone-outcome payment systems. The assignment rates in Phase 2, for both the milestone-outcome and outcome-only payment systems, are similar to the assignment rates in the early months of Phase 1. In both the Phase 1 and Phase 2 states, the number of Tickets assigned under the outcome-only system rose steadily, albeit slightly, from the beginning to the end of their respective rollout periods. The rise was more gradual in Phase 1, starting at about 7 Tickets in February 2002 and ending at 498 Tickets by August 2003. In Phase 2, the number of Tickets assigned under the outcome-only system rose from 2 in November 2002 to 384 by August of that year. In contrast, the number of in-use Tickets assigned under the milestone-outcome system in both phases rose more markedly over the rollout period. In Phase 1, the sharpest rise—from 65 to 299 Tickets—occurred from April 2002 to September 2002. The number if Tickets assigned then increased more gradually to 419 in February 2003, increasing slightly to 498 Tickets by August of that year. In Phase 2, the number of Tickets assigned under the milestone-outcome system was far greater, starting at a low of 25 in November 2002 and rising steadily to 1,277 by August 2003.

IV.6: In-Use Tickets by Provider Type - Consists of two stacked bar charts, one for each phase, that show the distribution of in-use Ticket assignments by provider type, by month for the period February 2002 through August 2003. In both phases, the percentage of in-use Tickets assigned to SVRAs increased over time, and the percentage assigned to ENs declined. In Phase 1, 82 percent of in-use Tickets were assigned to SVRAs in February 2002. The SVRA assignment rate rose to 87 percent in March, fell to 81 percent by May, and then gradually increased to its highest level, 91 percent, in August 2003. In Phase 2, 76 percent of in-use Tickets were assigned to SVRAS in November 2002. As in the Phase 1 states, the Phase 2 assignment rate initially fell, to 68 percent in December, and then gradually increased, to 82 percent in August 2003. In both phases, the time-patterns of the percentage of in-use Tickets assigned to ENs mirrored the SVRA rates just cited. That is, the EN assignment rate was initially relatively low, rose slightly, and then fell to a level below that initially observed.

IV.7: First Assignments and Net Deactivations - Consists of two clustered bar charts, one for Phase 1 and one for Phase 2, showing first Ticket assignments and net deactivations by phase from February 2003 to August 2003. In Phase 1, number of first assignments rose and fell erratically. Rising from about 134 in February 2002 to 676 in March and then to a high of 2,028 in August 2002, first assignments dropped markedly to 1,286 in September, jumped to nearly 2,000 in October, and then ranges between 642 and 1,315 range from November to June, with the final observed value being 811 in August 2003. In Phase 2, first assignments rose more steadily, with a sharp but consistent increase from 43 in November 2002 to about 712 in March, and then rising more gradually to just over 1,100 in July and August 2003. Net deactivations were nonexistent or very slight during the 10 observed months for Phase 2, as they were during the early months (February to September 2002) in Phase 1. From October 2002 to May 2003, net deviations for Phase 1 hovered at about 115, dropping slightly to 65 in June and holding steady at that level through August 2003.

IV.8: Ticket Participation Rates by Age, August 2003 - Shows a clustered bar chart showing the August 2003 Ticket participation rate in Phase 1 and Phase 2 by age. In both phases, the rate falls steadily with age—from 2.0 percent among beneficiaries age 18 to 24, to 0.1 percent among beneficiaries age 60 to 64 in Phase 1, and from 0.9 percent among beneficiaries age 18 to 24, to 0 for beneficiaries age 60 to 64 in Phase 2.

IV.9: Ticket Participation Rates by States, August 2003 - Shows a bar chart showing the variation in Ticket participation rates by phase and state in August 2003. Among the 13 Phase 1 states, Delaware had the highest participation rate, 1.9 percent, followed by Vermont at 1.4 percent and Wisconsin and Illinois at 1.2 percent each. Florida, Oregon, and Massachusetts were in a virtual tie for the lowest participation rate of .3 percent. The remaining six Phase 1 states had participation rates in the range of .4 percent to 1.0 percent. As would be expected given the later rollout of the Tickets during Phase 2 relative to Phase 1, the 21 Phase 1 states (including D.C.) generally had lower participation rates in August 2003 than did their Phase 1 counterparts. South Dakota was the only Phase 1 state with a participation rate greater than 1.0 percent. Its rate was 1.2 percent. Michigan was second with a .6 percent participation rate. Seven states were in a virtual tie for the lowest participation rate of .1 percent. The remaining 12 states had rates in the .2 to .5 percent range.

IV.10: Ticket Participation Rates by Primary Impairment, August 2003 - Shows the variation in Ticket participation rates by phase and primary impairment in August 2003. Phase 1 participation rates ranged from 4.4 percent for severe hearing impairment to 0.3 percent for impairments of the respiratory and circulatory systems. Phase 2 participation rates ranged from 1.3 percent for severe hearing impairment to 0.1 percent for 3 categories of impairments. For both phases, the most striking aspect of this figure is the relatively high rate of participation by beneficiaries with severe hearing impairments. That rate is roughly two to three times higher than the next-highest rates in the other categories of impairments.

IV.11: Ticket Participation Rates by Months Since Benefit Award, August 2003 - Shows a clustered bar chart showing Phase 1 and Phase 2 Ticket participation rates in August 2003 by month since benefit award. As would be expected given the different Ticket rollout schedules by phase, the Phase 1 rates were consistently higher then the Phase 2 rates. However, the pattern in the rates is similar for the two phases. Participation rates were lowest for the Ticket recipients who had been awarded benefits within the last 12 months or who had been awarded benefits more than 120 months earlier. Participation rates were highest and relatively constant for Ticket recipients who had been awarded benefits 25 to 120 months prior to August 2003. The Phase 1 participation rate peaks at .9 percent for Ticket recipients who had been awarded benefits 37 to 60 months earlier. The phase 2 rate peaked at .4 percent for Ticket recipients who had been awarded benefits 37 to 48 months prior to August 2003.

IV.12: Ticket Participation Rates by Months Since Ticket Mailed, August 2003 - Shows Phase 1 and Phase 2 participation rates for August 2003 by number of months since the Ticket was mailed. Phase 1 rates rose from 0.1 percent in months 0 to 3 to 0.4 percent in months 7 to 9, peaked at 0.9 percent in months 36 to 60, dropped slightly to 0.7 percent in months 13 to 15, and then rose again to 0.9 percent in months 16 to 18. During the nine post-mailing months in which we could observe the Phase 2 participation rates they were very close to the corresponding Phase 1 rates. The Phase 2 rates rose gradually from 0.2 percent in months 0 to 3, to 0.4 percent in months 7 to 9.

IV.13: Distributions of Provider Type and Payment Systems by State, Phase 1 Only, August 2003 - contains two stacked bar charts for Phase 1 states only. The first chart shows the distribution of in-use Tickets assigned by provider type for each of the 13 Phase 1 states. The second chart shows the distribution of in-use Tickets assigned by payment system for each of the states. The percentage of in-use Tickets assigned to SVRAs varies from virtually 100 percent in Vermont to 55 percent in Arizona, with only three states exhibiting values less than 80 percent—Oregon, Florida and Arizona. The percentage of Tickets assigned under the traditional payment system mirrors this pattern; states with a high proportion of Tickets assigned to SVRAs also have a high proportion of Tickets assigned under the traditional payment system. There are three important exceptions to this consistency between the two charts. Delaware, Oklahoma, and Vermont all have an SVRA assignment rate in excess of 97 percent, but the use of the traditional payment system in these states is notably lower, ranging from 52 to 87 percent.

IV.14: Distributions of Provider Type and Payment Systems by Age, Phase 1 Only, August 2003 - contains two stacked bar charts for Phase 1 states only. The first chart shows the distribution of in-use Tickets assigned by provider type for each of nine recipient age categories. The second chart shows the distribution of in-use Tickets assigned by payment system for each of the age categories. The age categories are in five-year increments from 18 to 64, with the exception of the first age category, which includes ages 18 to 24. The percentage of Tickets assigned to the SVRAs decreases rather sharply from 96 for the 18- to 24-year-olds to 91 for the 25-to 29-year-olds. It continues to decrease with age, although more moderately, until reaching 86 for the 60-to 64-year-olds. The percentage of Tickets assigned under the traditional payment system mirrors this pattern; age groups with a high proportion of Tickets assigned to SVRAs also have a high proportion of Tickets assigned under the traditional payment system.

VI.1: Ticket-Eligible Beneficiaries in AOI Groups 1 and 2, August 2003 - Shows a pie chart showing the proportion of Ticket-eligible beneficiaries in AOI group 1 (those needing ongoing support) and AOI group 2 (those needing accommodations) in August 2003. The largest share of beneficiaries, 53 percent, is in group 1. The next largest share, 39 percent of beneficiaries, is in neither of the AOI groups. The smallest share of beneficiaries, 8 percent, is in group 2.

VI.2: Distribution of Assigned Ticket for AOI Groups in Phase 1 States, August 2003 - Shows a pie chart showing the distribution of assigned Tickets for AOI group 1 (those needing ongoing support) and AOI group 2 (those needing accommodations) in Phase 1 states in August 2003. The largest share, 57 percent, is in group 1. The next largest share, 29 percent, is neither in neither of the AOI groups. The smallest share, 14 percent, is in group 2.