OBJECTIVES: The main objective of this study was to evaluate the cost effectiveness of the managed care in the case of heart failure. Also, the proportion of patients with a hospital free year was compared using managed care and non-managed care the non-managed care. METHODS: A meta-analysis was used to estimate the effectiveness (hospital free years). Cost effectiveness was analyzed in two perspectives: the program’s and the payer’s. In the program’s perspective, the literature was used to estimate the cost. In the payer’s perspective, Thomson Reuter’s MarketScan data were used to estimate the cost. RESULTS: It was found that, in the program’s perspective, a hospital free year’s cost was $8,872.60 while in the payer’s perspective by using managed care; it saved an average of $53,109.22. The proportion of individuals with a hospital free year in managed care and in the usual care were not found to be statistically significant. CONCLUSIONS: Even though managed care did not have a different hospitalization usage than standard care, it was found to be cost-effective for the payer.