JSA Healthcare plotting growth plans.

Like planning strategy in the world-conquest game of Risk, JSA Healthcare Corp.'s management team plots acquisitions in the "War Room."

Maps stuck with color-coded pushpins line the walls and identify facilities owned and operated by JSA -- and desirable properties -- each labeled with the number of Medicare patients living in the vicinity.

JSA's success came after top executives developed a strategy of narrowly defining a smaller world to conquer -- a niche market.

Gary Damkoehler, chief executive officer and president, decided years ago to concentrate on managing primary-care physician practices instead of specialty care. He further narrowed the …