Mortality in epilepsy remains a major public health concern. While SUDEP remains an important issue, especially in clinical research, it accounts for only a small portion of overall mortality in patients with epilepsy. The current study looks beyond SUDEP and evaluates overall outcomes in epilepsy mortality based on level of specialist care, showing convincing evidence that specialist referral reduces overall mortality. The study does not address why specialist referral decreases mortality. However, considering the multifactorial etiologies for mortality in patients with epilepsy, comprehensive evaluation by an epilepsy specialist actively addressing individual needs for care conceptually offers a framework to address the multiple issues which affect a patient’s health and subsequent outcomes, including mortality. Given the many effective proven treatments for epilepsy, including medications, and advanced treatments such as epilepsy surgery, the study provides further evidence of the importance of specialty epilepsy care. In an era of increasing limitations of resources and reimbursements for specialty services, this study also speaks to the importance of maintaining allocations of resources to epilepsy specialty centers for patients with epilepsy to have access to specialty care.