The effectiveness of a standardized telephonic case-management intervention in decreasing resource use was tested in patients with chronic heart failure in a randomized controlled clinical trial. Patients were identified at hospitalization and assigned to receive 6 months of intervention (n = 130) or usual care (n = 228). Hospitalization rates, readmission rates, hospital days, days to first rehospitalization, multiple readmissions, emergency department visits, inpatient costs, outpatient resource use, and patient satisfaction were measured at 3 and 6 months. The heart failure hospitalization rate was 48% lower (P = .005) at 6 months and inpatient costs were 45.5% lower, which more than covered the costs of the intervention. Heart failure hospital days and multiple readmissions were significantly lower in the intervention group as well. The reductions in resource use achieved with this intervention were greater than those usually achieved with pharmaceutical therapy and comparable with other disease management approaches.