PurposeThe process of performance measurement provides support to company management to achieve the objectives established in strategic planning. Through the definition of critical success factors and related key performance indicators, performance measurement verifies the gap between planned objectives and the results achieved, informing the responsible bodies to enable them to evaluate performance and, if necessary, implement improvement actions. Although many types of companies adopt performance measurement, this process is challenging when applied to national health services. This paper aims to identify the evolution of performance measurement and the critical success factors of national health services.Design/methodology/approachThe authors conducted an explorative case study of a leading national health service to delineate the evolutionary path of performance measurement and the main critical success factors.FindingsThe results indicate a significant increase in the maturity of performance measurement of a national health service that has been motivated by international reforms and national regulations. This research highlights performance measurement features such as a balanced set of metrics, targets, and incentives linked to strategic objectives and regular and frequent performance reviews. Furthermore, it identifies the performance measurement model of a leading national health service.Originality/valueThe evolution of performance measurement and numerous critical success factors of national health services are described; the critical success factors cover a wide range of financial to operational aspects such as patient safety, organizational appropriateness, and clinical appropriateness.