The Health Resources and Services Administration (HRSA) does not specify the exact number of peer reviews that must be completed. In contrast, HRSA expects health centers to maintain an ongoing, well-documented process for evaluating the quality of care that is provided by their clinical staff.  

As outlined in Chapter Five: Clinical Staffing, of the HRSA Health Center Program Compliance Manual, peer review is recognized as a key component of evaluating provider performance and ensuring clinical staff meet the professional standards of care. Peer review and/or performance improvement activities must be considered when completing the reappointment process, which typically occurs every two years. This process helps to confirm clinical staff are delivering safe, effective and appropriate care, within the scope of their approved privileges.  

Additionally, Chapter Ten: Quality Improvement/Assurance, of the HRSA Health Center Program Compliance Manual, states Quality Improvement/Assurance assessments must be completed on a quarterly basis. Peer review is considered a QI assessment; therefore, health centers are required to complete peer review a minimum of quarterly to identify trends and address areas of risk.  

Industry standard best practice demonstrates the completion of a minimum of five charts per provider per quarter. Peer review must be completed for all services in the health center’s scope of project and must be completed between providers within the same specialty who are similarly credentialed.  While HRSA does not specify a required number of peer reviews, the goal is to complete enough to meaningfully evaluate provider performance and promptly address any concerns. Delaying or reducing the number of peer reviews increases the likelihood of uncovering performance issues only after patients, or the health center, have already been placed at risk.