Healthcare planning forms a key instrument for decision makers to influence and direct health service provision, a function which is likely to become more important in the light of increasingly complex challenges that demand innovative solutions. How this is achieved best and in what circumstances remains however uncertain, given the variety of approaches adopted in different settings. This report aims to contribute to policy learning across countries from the diversity of healthcare planning approaches in Europe and elsewhere through developing and validating a framework for assessing, improving and enhancing healthcare planning. It identifies a set of criteria within three broad themes: "Vision", "Governance" and "Intelligence", which were then tested empirically through an in-depth analysis of four countries, using a case study approach: Germany, Austria, Canada (Ontario) and New Zealand.