This article details the development of Healthy Alaskans 2020, Alaska's statewide health improvement plan. Healthy Alaskans 2020 is a framework that supports collaborative efforts among many agencies and communities working toward the common goals of improving health and ensuring health equity for all Alaskans. The initiative was created through a unique tribal-state partnership between the Alaska Native Tribal Health Consortium and the Alaska Department of Health and Social Services. Through an iterative process using the best available epidemiologic data and extensive community input, Alaskan's health priorities were identified, with 25 leading health indicators and accompanying targets to be met by 2020. Two indicator scorecards, one for all Alaskans and one specifically for Alaska Native people, are updated annually and used for continual monitoring. The collaborative and iterative nature of Healthy Alaskans provides a model for others interested in creating multisector health improvement initiatives that align goals across systems and partners.