There is substantial opportunity to reduce health care costs through prevention of heart failure. Team-based management of medical homes and large populations will be important for the success of any prevention interventions. Clinical trials of treatment are needed to show that heart failure is reduced by treatment. A team-based approach to treatment of asymptomatic left ventricular systolic dysfunction (LVSD) can work well with the availability of electronic medical records and a population approach to health. Attention should be given to optimizing risk factor reduction and preventive treatment with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and β-blockers if LVSD is present.