Heart failure is a growing pandemic affecting approximately 6.2 million people in the US and 15 million people worldwide. Mechanical circulatory support devices are not only a bridge to transplantation, but have become destination therapy for a large portion of this population. Given its prevalence and high morbidity and mortality leading to significant financial burden on our healthcare system, establishing strategies focused on improving therapeutic outcomes and prognosis should be prioritized. Delivering care to such a large and complex patient population poses unique challenges given the progressive care needs and extensive follow-up. Time and distance traveled are among the limiting factors that disable patients from having access to life sustaining advanced therapies such as the LVAD. This chapter aims to review the traditional care model and expand on the necessary tools and benefits of the LVAD shared care model in delivering care to previously underserved patient populations with advanced heart failure.