Patients hospitalized for decompensated congestive heart failure are among the highest risk group for morbidity and mortality among people with chronic heart failure and a large proportion of this risk occurs early after discharge. Thus, the goals of these programs should include managing the gap between the inpatient and outpatient settings and should ideally involve a multidisciplinary team in order to serve these patients in a comprehensive manner. We propose to determine the relative efficacy of a post-discharge disease management system.