Many nations throughout the world have recognised the need to introduce healthcare reform policies to encourage innovation and contain, or reduce, healthcare expenditures. Countries have renewed their interest in how healthcare systems perform. While the reform agenda of each country is different, there is a common thread of managing healthcare systems to achieve effectiveness, efficiency, and, in many instances, some form of equity of access to services. This paper reviews the background of the various healthcare system reforms currently being undertaken from a healthcare management perspective. It seeks to identify the various categories of management skills that are required to support the desired reform. The rapid change in the healthcare environment requires a broader approach to the education of healthcare managers. Using simulation as part of the education and training provides a safe environment to apply formal learning and thereby increasing the depth of knowledge. This paper focuses on identifying the skills required to support health reform and how simulated health management could support the education and training of healthcare managers.