Cost and quality outcomes of comprehensive epilepsy monitoring review of referrals in a managed Medicaid program

The proceedings of the National Institute of Health's "Consensus Development Conference on Epilepsy Surgery" was published in March 1990. In it, the conclusion was made that, while surgery for intractable epilepsy can stop or decrease documented seizures, "effects in overall health status and quality of life have not been adequately studied." Recommendations for standardized data collection for surgery in qualified, technologically-equipped centers included the need for follow-up studies of outcomes for at least five years. The University of Arizona's Epilepsy Center was established in 1984, and the Arizona Comprehensive Epilepsy Monitoring Program started at the University of Arizona Health Sciences Center in 1990. Patients from various payer sources have been managed, and many surgeries have been performed. This report focuses on patients covered under the state's managed Medicaid program for patients under a full-risk, capitated managed care contract with University Physicians. The Arizona Health Care Cost Containment System (AHCCCS) contracted with University Physicians, Inc., of the University of Arizona Health Sciences Center, for comprehensive health care services under a capitated payment mechanism from 1982 to 1992. Thereafter, University Physicians has provided services through subcontracts with other managed care organizations. This report focuses on this Medicaid population.