Background: Hospitalization due to heart failure (HF) is a strong predictor of adverse outcomes. This study sought to what extent previous HF admissions impacted on the success of a disease management program (DMP) to reduce readmission. Methods: We prospectively enrolled 1363 consecutive HF pts, who were followed for 3 months after discharge. Of these, 431 (31%) received a DMP (1-month duration, including post-discharge home visits, medication reconciliation, exercise guidance and early clinical review). Study outcomes were all-cause readmission or death at 30- and 90-day post-discharge. Previous HF admissions were collected from medical records. Results: Of the 1363 HF patients, death or readmission occurred in 386 (28%) at 30 days and 556 (41%) at 90-days post-discharge. Compared to 765 patients without any previous HF admission ever, the 143 patients with a previous HF admission >12 months before the current admission had no higher risks of readmission or death at 30 days (relative risk) and 23% higher risks of readmission or death at 90 days. The 420 patients who had a previous HF admission ≤12 months from the current admission had higher risks of the composite outcome at both 30 and 90 days (Table). DMP was not associated with any reductions in risks of adverse outcomes at both 30 and 90 days among patients with a previous HF admission in ≤12 months, but was significantly associated with a reduction in risks at 30 and 90 days (Table) among those without any previous HF admission in ≤12 months. These findings were independent of HF severity, systolic and diastolic function, comorbidities, cognitive function and any demographic or socioeconomic factors. Conclusion: Higher levels of attention should be focused on HF patients with a recent prior HF admission who have higher risks of post-discharge adverse outcomes and appear to be non-responsive to a DMP to reduce readmission.