Asheboro, N.C.-based Randolph Health and Greensboro, N.C.-based Cone Health have entered into a period of due diligence to explore possible affiliation models.
Officials said they hope to make a final decision regarding the type of partnership and sign a formal letter of intent by the end of May.
The organizations entered into a management services agreement in May 2016.
"Healthcare continues to change at an unprecedented rate," said Steve Eblin, CEO of Randolph Health. "The demands for expertise in population health management, the costs of improved technology and lower payment from governmental sources make it difficult for health systems the size of Randolph to thrive. A stronger relationship with Cone Health will give Randolph Health the additional efficiencies, expertise and resources it needs to grow and continue providing outstanding healthcare for the communities we serve."