Background Heart failure (HF) remains a major contributor to morbidity and mortality, with repeated hospitalizations driven by suboptimal post-discharge follow-up. To address this gap, we implemented a multidisciplinary transitional care program aimed at supporting HF patients during the critical post-discharge period. Hypothesis Enrollment in a structured transitional care program reduces hospital readmissions and ED visits at 30, 60, and 90 days compared to standard care. Methods Between August 2018 and January 2024, HF patients admitted to our facility were referred for a 30-day transitional care program. Participants received personalized care plans developed by dedicated care managers in collaboration with HF specialists and primary care physicians. Core components included patient education, remote monitoring, 24-hour telephone support, and scheduled follow-up appointments. Enrolled patients were 1:1 matched with non-enrolled controls using the Health-Based Allocation Model Inpatient Group (HIG) score. The primary outcome was a predefined composite of 30-day readmission or ED visit; secondary outcomes evaluated these events at 60 and 90 days. Results Among 511 matched pairs, program enrollment was associated with a 37.6% reduction in the composite 30-day outcome (OR 0.62, 95% CI: 0.47-0.83, p<0.001; NNT=8). Similar benefits were observed at 60 days (36% reduction, OR 0.64, 95% CI: 0.50-0.83, p<0.001; NNT=10) and 90 days (34% reduction, OR 0.66, 95% CI: 0.51-0.84, p<0.001; NNT=10). Conclusion A structured transitional care program delivering multidisciplinary support, patient education, and prompt post-discharge follow-up significantly reduces readmissions and ED visits among HF patients, with benefits sustained through 90 days. These findings highlight the value of coordinated supportive care in improving HF outcomes and suggest this approach will potentially reduce healthcare costs for this patient population.