Heart failure (HF) is a new epidemic in the United States. Advanced HF is a fatal illness affecting our veterans and causing frequent hospital readmissions in both the Veterans Affairs hospital and throughout the nation’s healthcare system. The clinician’s obligation is to offer the best alternatives in the care of chronic illness. The Veterans Affairs healthcare system has a comprehensive approach to treating HF. The comprehensive implementation of home telehealth, clinical informatics, and disease management supports the care of patients with advanced HF.