Comprehensive tracking of health expenditure is essential to assess the performance of health systems and to support evidence-based decision making. For this reason, nearly all OECD countries produce annual data on health expenditure and financing based on an international accounting framework: the System of Health Accounts. However, the way in which this framework is implemented must reflect national health system characteristics, country-specific priorities and other considerations. This report provides the first in-depth analysis on the state of institutionalisation of the production of health accounts in 13 OECD countries. These experiences tease out good practices regarding the governance of the production process, the technical aspects of producing health accounts, and the dissemination of the results, including their use to inform policy making. The report will benefit all countries that have not yet fully institutionalised health accounts as well as those that wish to review and refine some aspects of their institutionalisation practice.