Chia-Yi hospital is ever a 120 years long-standing public hospital in southern Taiwan. But in recent decade there were evolution of healthcare insurance, marked reduction of public budgets and competition from surrounding hospitals in outside environment. Lots of inside problems challenged the hospital including delay of reconstruction, insufficient healthcare staffs, outsourcing of core medical services and scandals about investment affairs for medical equipments. The hospital was in crisis due to decreasing profits. Following superintendent Huang’s scandal superintendent Hsu, who was assigned in 2011, renewed the vision and goals of the hospital with all staffs, enforced equipments and human resources, and planned alliance with medical center to improve and upgrade the hospital. Vice-superintendent Pai took the position in July 2012, became temporary superintendent in August 2014 and intended to assure the quality and performance improvements. The hospital really had risen from the ashes by efforts of all staffs and collaboration through hospital alliances as compared to previous condition. Thereafter superintendent Chen took over in March 2015, and focused more on cost-saving and profit promotion in hospital management. While upgrading as regional hospital, Chia-Yi hospital would compete with allied hospitals but could it be possible to progress further without hospital alliance? In the mean time, would the hospital take higher risk to survive by itself when facing higher healthcare costs but lower budget supports? It is like ‘Dances with Wolves’, as most hospital staffs said, when we cooperate with the competitor. Competition will be a new problem when patients shift to alliance hospital gradually in the future. What will be the direction and right way to further cooperation by alliance? This article discusses so ambiguous solution in hospital management as to make the decision on not only reengineering of the hospital internally but also defining the strategy of co-opetition externally now.