Health officials say they are committed to the future of two district general hospitals (DGH) after a leaked report had said they would be downgraded.
A draft report by Hywel Dda Health Board said Bronglais in Aberystwyth and Withybush in Haverfordwest would become rural general hospitals (RGH).
But the board said the report, dated 9 July, was out of date and the hospitals would continue to be DGHs.
In 2006, a review threatened the future of hospitals in mid and west Wales.
At the time, about 1,000 people marched through Aberystwyth to protest against proposed changes to services at Bronglais Hospital.
The "outdated" proposals were revealed in a leaked report by the Hywel Dda Health Board, dated 9 July, 2010.
The board is responsible for Bronglais, Withybush, West Wales General Hospital in Carmarthen and Prince Philip Hospital in Llanelli, which are all DGHs.
In its report, it said Bronglais and Withybush would become RGHs offering fewer services than a DGH, and losing departments such as intensive care units.
But the Hywel Dda board said that report was now out of date.
In the up-to-date version, it proposes to change the way health care is delivered in the community, which means more "high quality services and care delivered closer to home".
The chief executive of Hywel Dda Health Board, Trevor Purt said: "We are currently developing plans for major investment in community services in the Hywel Dda area, which will focus on ensuring local people have access to the right services, in the right place, at the right time - every time.
"These plans are still under development, but we propose significant investment in improving our community and primary care services, providing more care in the community, within people's own homes, and with a greater focus on the management of long terms conditions.
"We would anticipate that this would lead to less demand on hospital beds and services. It may be necessary to centralise on fewer sites specialist services that require a minimum number of patients to deliver the high standards that we require and the best outcomes for our patients."
Closer to home
He added: "We are committed to ensuring our four main hospitals remain as major health care providers and those designated as district general will continue to be so.
"We are hoping to finalise our plans later this week, which we will of course then be discussing in detail with our stakeholders across all three counties."
The health board said its new report, which is a five-year proposal, was a response to the Welsh Assembly Government's rural health plan from 2009.
The board said changes were needed because too often many people ended up in hospital because there was no other service available, and they stay longer than they need to for the same reasons.
It added that the population in west Wales was older than in other parts of the country, and as a result there are many people with chronic (long term) conditions who needed help closer to home.
It explained that health needs of people were not the same today as they were 10 or 15 years ago when existing community services were designed and that was another reason for change.