Evaluation of the Ticket to Work Program Initial Evaluation Report

C HAPTER IV
E ARLY P ARTICIPATION P ATTERNS
D
uring the 19 months since TTW began its rollout, SSA has mailed Tickets to more
than 5 million beneficiaries. While only a tiny portion—less than 1 percent—of
those beneficiaries has participated, the participation rate has been steadily
increasing. In addition, participation rates among some Phase 1 subgroups and states exceed
1 percent and are as high as 2 percent. Thus, the participation patterns observed thus far
leave room for cautious optimism. They suggest that, despite administrative start-up
problems and the difficulty in recruiting providers, participation is slowly increasing and that
rates might increase further if SSA can identify and replicate the factors that account for
higher enrollments in some states and among some subgroups.
At the same time, it is clear that, while TTW has expanded beneficiaries’ choice of
providers, most of the participation has been with SVRAs using the traditional payment
system. Only 16 percent of Tickets are being used under the two new payment systems.
The pattern suggests that TTW does not yet represent a dramatic break from the past.
Instead, its progress so far represents the introduction of new choices and incentives whose
ultimate effect will depend on the eventual level of participation and the extent to which
ENs and SVRAs offer newer and more effective services.
This chapter presents early participation statistics on the dynamics of the rollout from
its February 2002 start through August 2003, the last date for which data were available for
the current analysis. We examine the number of eligible beneficiaries who have been sent
Tickets, the share of such beneficiaries whose Tickets are in use (i.e., the “participation
rate”), in-use Tickets by payment type and provider type, first-time assignments, and Ticket
deactivations. We then consider the characteristics of eligible beneficiaries and examine how
participation rates vary with those characteristics. We also consider how provider and
payment type vary with the characteristics of beneficiaries with Tickets in use. We conclude
the chapter with a synopsis of the findings. Appendix A presents tables that support the
figures presented in this chapter.