Increasing demand for healthcare services, due to changes in demographic shifts and constraints in healthcare funding, make it harder to manage effective, sustainable healthcare systems. Many healthcare modeling exercises have been undertaken with the aim of supporting the decision-making process. This paper reviews all of the 456 articles published by the Winter Simulation Conference over the past 48 years (1967–2015) on the subject of modeling and healthcare system simulation, and analyzes the relative frequency of approaches used. A multi-dimensional taxonomy is applied to encompass the modeling techniques, problem applications and decision levels reported in the articles. One of the most significant changes in the modeling of healthcare systems is the fact that Discrete-event Simulation (DES) is no longer used as an autonomous method, but rather as an integral part of the solution. The mixed-methods, hybrid and multi-paradigm approaches feature strongly in the current direction of modeling in healthcare systems.