Decreasing hospital readmissions in heart failure (HF) patients represents the primary goal of HF management to improve patient survival and quality of life and resource use. The wide Italian network of outpatient HF clinics may play a pivotal role in achieving this aim through the appropriate implementation of tailored patient follow-up. This tool rests on accurate risk stratification to identify complex unstable patients who should be referred to an HF clinic. Patient selection is crucial for an appropriate allocation of scarce specialist resources, but data from the IN-HF Registry demonstrate that it is currently inadequate. Over one third of patients followed up at the network of outpatient HF clinics for at least 2 years are stable, at low clinical complexity, showing significantly lower mortality and readmission rates than those of unstable patients. This document, promoted by the Italian Association of Hospital Cardiologists (ANMCO) Working Group on Heart Failure, summarizes the opinions of leading experts on the best use of clinical evaluation and laboratory testing to help the cardiologist plan a rational follow-up strategy tailored to the individual needs of each HF patient. (G Ital Cardiol 2010; 11 (5 Suppl 2): 55-75)