Parliament has been told that district health boards are managing their finances better than in the past, but there is still a significant risk of deficits in the sector.
The Crown Health Financing Agency also told MPs on Wednesday that there is a risk of industrial action over pay talks in the health sector - which will add further financial pressure on all boards.
The agency is the sector's banker. It told the Health Select Committee that unplanned spending by DHBs as a group dropped from $100 million in December 2008 to less than $20 million last December.
But it says finances remain stretched, with 16 of the 21 boards in deficit, six substantially, and others projecting year-end results that are worse than budgeted for.
The agency says long term, revenue growth will be lower than DHBs might expect, and they will have to think regionally and involve clinicians in decisions about services.