Probably both. What prop do you have on there now?
To expand a little bit... They run as lean as possible for emissions sake, so adding altitude only complicates that. They also need to get up in RPM to deliver that rated HP anyway, so if you can't get the RPM up with the load of the boat, you'd need a prop change to accomplish that. The HP is also directly impacted by the elevation change, so you're probably taking a 15% hit there so if the current prop is not getting you up in RPMs at sea level, it's going to have a much harder time at 6,000 ft.
Now, if you're lugging the boat because you can't get to the RPMs, then it's really critical that you don't also go lean, because that could have devastating consequences. So, to answer your question o which is "more important", I'd point to the rejet if I could only do one or the other. The rejet might not get you to the performance you need/want, but it might save the engine from destroying itself.