The Nelson-Marlborough District Health Board is considering a merger of some services with its West Coast counterpart.
The organisations would share a management team and some clinical services, but retain their own boards and funding.
Nelson-Marlborough DHB chairperson Suzanne Win says her area does not suffer the recruitment problems that the West Coast board experiences.
But she says it would benefit from the greater influence a larger population brings, when it comes to planning health services.
West Coast District Health Board chairman Rex Williams says the region's funding is limited because of the population-based funding system, and its remote location makes recruitment difficult.
He says the proposal is aimed at improving services rather than cost savings and residents would benefit through access to the larger organisation's resources.
The boards say potential savings are not yet known, but it is likely some administrative and planning jobs would be cut by attrition or voluntary redundancy.