The chapter reviews the state of the art of telemedicine and remote care in the home and the economic and organizational factors that impinge on its future success. Because of the constraints of distance, costs, and availability of providers (doctors and nurses) in specific areas of medical specialties, the model of treating patients in the general hospital is losing its luster in favor of dedicated clinics dispersed in the community and remote care in the home. Such a trend of decentralization of medical services has been in existence for some time. Yet, although technologies are quickly evolving and the need for telemedicine and home care is increasing, the progress of this mode of delivery of medical services has not kept up with the demand. The chapter attempts to review the economic and organizational factors which act as facilitators and barriers to the rapid diffusion of telemedicine and home care. In particular, the chapter explores the case of chronic diseases, and also offers a valuable comparison between two systems of national healthcare: the Italian and the American.