All Australian governments agreed the National Healthcare Agreement (NHA) in 2008. The objective of the agreement is to improve health outcomes for all Australians and ensure the sustainability of the Australian health system. Governments recommitted to the agreement in 2011, and reviewed and agreed to a much streamlined structure in 2012. We assess and report publicly on the performance of all governments against the outcomes in the agreement. This year, we focus on whether these outcomes have improved over the five years since the agreement was developed. We assess progress over time and identify trends.