The Marshall Islands Health Ministry says it has plans for the construction of a new hospital costing US$77 million in Majuro.
Our correspondent Giff Johnson says the United States government is likely to be asked to fund construction through its Compact of Free Association infrastructure money.
He says if it goes ahead the hospital will be the Marshalls' largest ever construction project and US officials say ongoing maintenance costs would be prohibitive.
"The bigger the facility, the more costly, the higher the ongoing maintenance fees. And the concern that, given the lack of maintenance on most government buildings here, that it would really be a problem for sustainability."
Giff Johnson says the US is waiting for the Marshall Islands to say how the proposed new hospital fits with the Ministry's vision of decentralised health services and an increased focus on public health.