Japan's Health Care System has experienced a number of changes over the last half a century. And the most heated aspect of current health policy debate focuses on the potential radical reform of the medical care system. In addition, the regional medical service organizations are in front of a more severe challenge because of the rapidly aging population and decreasing young population. Consequently, hospitals and other NHS organizations in local areas have been required to introduce reforms in their management structure for their survival. This paper reports in depth on a case study of a private Japanese hospital, the Chikamori medical group, to introduce a key competence-based management model and differentiation marketing strategy. As one of the regional medical care support hospitals, Chikamori plays an active and important role in the regional medical care network. The case implies the effective business model based on positioning in the network architecture, which is significant not only for medical service field but also for other regional industries. The mutual correlations among financial strategy, human resource design, managing policy and collaboration manner with regional doctors are discussed in the paper.