Ross–Loos Medical Group was a comprehensive prepaid health services plan with 29 medical offices throughout Los Angeles, Orange, Riverside, and San Bernardino Counties in California and a large multi-specialty hospital located on Temple Street, Los Angeles. Founding Ross-Loos was established in 1929 by two physicians, Donald E. Ross and H. Clifford Loos, older brother of writer Anita Loos. The plan consisted of monthly payments which assured benefits of medical and hospital care to over two thousand employees of Los Angeles County and the Department of Water and Power and their families. The founders believed that health care could be improved by combining prepayment of services, eliminating the financial barriers faced by patients at the time of needed care, with the sharing of medical records and the ease of consultation in a medical group. The focus was on the improvement of medical care quality, rather than financial success, and many concepts in those plans built on a public health approach that encouraged prevention. The plans included prenatal care, well-baby visits, and immunizations in standard benefit packages, with small or zero co-payments, at a time that even the hospital costs of maternity stays were often excluded from traditional insurance. Ross–Loos Medical Group (1929) is the first HMO in the United States, the term "managed care" came about chiefly through the influence of U.S. President Nixon on February 17, 1971. Over several years many other employee groups, mostly governmental, joined the plan. Ross-Loos was so successful that the first small medical office on Grand Avenue in Los Angeles expanded into an enormous organization with 29 medical offices and a large multi-specialty hospital, on Temple Street, Los Angeles, by 1979. Purchases In 1980, Ross–Loos Medical Group was purchased by the Insurance Company of North America (INA) HealthPlan (see HMO International and California Medical Group and merged into its medical office operations which created over twenty-nine medical office locations throughout southern California. Its new name was "INA and Ross-Loos HealthPlans". This new operational name was in existence a short time until 1982; through a merger of the Insurance Company of North America (INA) and Connecticut General (CG) their names changed to become CIGNA. Ross–Loos Medical Group, became known as CIGNA HealthPlans of Southern California and was merged into the large CIGNA Employee Benefits Division. In 1997 CIGNA made a decision to divest itself of its "owned delivery system" or "staff model" (see HMO – staff