The Rothman Institute on Friday became the first large, independent physician group to sign an insurance contract under Independence Blue Cross' facilitated health networks model, which is designed to foster collaboration between the region's largest health insurer and the hospitals and doctors who provide care to the people Independence insures.

Under the five-year deal, which starts July 1, Rothman and Independence will expand their "bundled-payment" arrangements, under which a doctor is in charge of all the care provided for major joint replacements and other procedures, including services provided before and after the main surgery.

Independence has similar facilitated health network contracts with the University of Pennsylvania Health System, Jefferson Health, and others. The model represents Independence's effort to work as close as possible with health care providers without getting into that business, as has happened in other parts of Pennsylvania where health systems sell insurance and insurance companies own health systems.