Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.

Q: Paragraph: As part of President Barack Obama's healthcare reform law, the efforts center around more than 360 accountable care organizations (ACOs), which are networks of doctors, hospitals and other providers specially organized to help move Medicare away from traditional fee-for-service medicine. The U.S. Centers for Medicare and Medicaid Services (CMS) said preliminary data show that the ACOs produced $380 million in savings vis-a-vis traditional Medicare in 2012 by giving doctors and other healthcare providers the incentive to focus on improved outcomes for patients instead of fees from tests and services. Medicare, the $575 billion government healthcare system for 51 million elderly and disabled beneficiaries, faces growing financial pressures as a result of America's aging population. A mainstay, the trust fund that pays for hospitalization, is expected to be exhausted in 2026. Deficit hawks view Medicare as a future driver of the federal debt and have called for major systemic reforms. But the Obama administration has pursued gradual changes including the reform of care delivery systems. So-called fee-for-service medicine is widely viewed as a cause of rising healthcare costs, because it calls for paying healthcare providers for tests and services that are sometimes unnecessary. Obamacare seeks to tackle costs by exploring ACOs and other new healthcare business models intended to find savings that do not jeopardize care. A main goal is to generate savings large enough to be shared between Medicare and providers. But some experts are skeptical, saying significant cost reductions could be hard to maintain over time. But CMS, an agency within the U.S. Department of Health and Human Services, runs two different ACO programs. In its largest, 54 of 114 ACO networks achieved lower than expected expenditures. But only 29 saw savings big enough to share with providers. All told, the program produced $128 million in net savings for Medicare's trust funds. "Overall, the ACO program's a net saver to the Medicare program," CMS principal deputy administrator Jon Blum told reporters in a conference call. "It's giving us great confidence that this is the right course for the Medicare program and we are confident that it will continue to show quality improvement and cost savings." Officials said the ACOs also achieved a wide range of quality goals. But CMS released no quality statistics. Thursday's government release drew some cautious optimism from the healthcare industry. "Today's report reflects important steps. More work is needed to modernize our antiquated Medicare payment system and base payment on evidence-based quality measures and proven patient outcomes," said Dr. John Noseworthy, chief executive of the Mayo Clinic in Rochester, Minnesota, which is not part of the government's program. "As results of the team-based care models are analyzed, those most effective in driving down health care costs without compromising safety and quality should become part of the healthcare system," he said. Claim: U.S. says results encouraging for healthcare delivery reforms.

A: The Obama administration on Thursday reported what it called encouraging results from efforts to reduce healthcare costs and improve the quality of care for more than 5 million Medicare beneficiaries under Obamacare
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Q: Paragraph: "Of more than 300 men and women who had the surgery, a third stopped playing sports entirely and 68 who were still active said they didn't play as well as before, researchers reported in the American Journal of Sports Medicine. The anterior cruciate ligament, or ACL, is the ligament inside the knee that helps keep the joint stable. About 150,000 ACL injuries occur each year in the United States. "Less than 50 percent of the study sample had returned to playing sport at their preinjury level or returned to participating in competitive sport when surveyed at 2 to 7 years after ACL reconstruction surgery," wrote Clare Ardern at La Trobe University in Victoria, Australia, who led the study. Ardern and her colleagues followed more than 300 men and women for two to seven years. Participants had either played Australian-rules football, basketball, netball or soccer before their surgeries. At 39 months post-surgery, 208 out of the 314 people who had the operation were still playing a sport, the researchers said. Of those 208, 68 said they played at a lower level than before their injury and 140 said they played about the same as before their injury. The remaining 106 participants either were not playing sports or did not complete the entire study. "Although almost all people returned to playing some form of sport, they did not play continuously for many years after their surgery," Ardern told Reuters Health in an email. She also noted there may be other reasons why people stopped playing sports, such as fear of getting injured again or less confidence in performing. Of the 196 people who played competitive sports before their injury, 91 returned to their competitive sport. "This is a big injury," said Edward McDevitt, a spokesman for the American Academy of Orthopaedic Surgeons, who was not part of the study. "Many athletes who choose surgery have a long and difficult road to face. If you're not willing to go through it, then you might be better off just getting a brace." He added that while knee surgery does allow people to return to their sport, they couldn't perform as well as doctors might wish. People who tear the ACL can either opt for physical therapy and surgery or just physical therapy alone. "Some people find that they are able to function well without surgery, provided they have adequate leg strength to support the injured knee," Ardern said. "Other alternatives may be to avoid sports involving direction changes, jumping and landing or activities that make the knee feel unstable, or use knee braces and supports." McDevitt speculates that after surgery, some athletes may not have the same range of motion, preventing them from playing as before. ""I tell my patients, 'I can't make you like before, I'm not God. But I'll do the best I can to restore you back to the way you were,'"" he added. SOURCE: bit.ly/pWId18" Claim: After knee repair, half can't play sports the same.

A: After knee reconstruction surgery, half of people who played sports both competitively and just for fun don't perform as well as they used to, according to an Australian study.
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Q: Paragraph: That could all change with a controversial Nov. 4 ballot initiative in which voters will get to decide for the first time whether to abolish a 1963 state law designed to protect small businesses. The law requires North Dakota pharmacies to be owned by local pharmacists or run by hospitals with a local pharmacist on staff. Supporters of the initiative argue it will remove an embarrassing anachronism, give consumers more choice and lower prescription drug costs. Opponents say that allowing national chains would destroy North Dakota's tradition of personalized pharmacy care and be yet another example of how the state's neighborly way of life is changing too fast. Canada, Germany, France and many other countries, they also note, have similar laws requiring local pharmacy ownership. "Independent pharmacies are more apt to focus on customer service," said Gabe Gretz, who bought Service Drug Pharmacy in Williston last year with his father. "This is our bread and butter. It's not just a hobby for us." "North Dakota Nice" is a truism here, not an irony, and most retail stores are still prohibited from opening before noon on Sunday - a throwback to laws designed to encourage family time. Yet since the oil boom began around 2010, drawing thousands of new residents to jobs where roughnecks can earn more than $100,000 a year, drug use, assault and other violent crimes have jumped. Recent sex-trafficking charges brought against an oil field worker in Williston, a once quiet town that is now the epicenter of the boom, marked the first charges of that type ever filed in the area and has escalated tension between new and old residents. Many newly arrived oil workers, and even some locals, say they hope the ballot measure passes so that they can use the same chains they've grown accustomed to elsewhere. Rite Aid Corp has no outpost in the state, North Dakota's Walmarts have no in-store pharmacies and the state's lone Walgreens, on the Minnesota border, is prohibited from selling prescription drugs. CVS is able to operate only a handful of pharmacies in North Dakota thanks to a 2006 buyout of several Osco Drug stores that operated before the 1963 law. "Honestly, it's not convenient getting my prescriptions here," said Jan Anseth, a resident of Williston who spends winters in Arizona where she gets her medications from a national chain. In North Dakota, Anseth says, she runs into problems transferring prescriptions and getting anything more than a 30-day supply. The ballot's primary sponsor, North Dakotans For Lower Pharmacy Prices, was funded with $168,000 in contributions from Walmart, Walgreens, Kmart and others. In campaign materials, the group cites data the Kaiser Family Foundation compiled in 2009 showing North Dakota has one of the highest per capita costs for prescription drug and medical devices in the country. Walmart says North Dakotans are missing out on its popular $4 prescription program, which makes many generic drugs available at the sharply discounted price. Crying foul, the state's independent pharmacists say they're able to often meet or beat prices from national chains, most of whom lose money on pharmacy sales as a way to get customers in the door. A random survey by Reuters of North Dakota's independent pharmacies showed that a 30-day supply of the generic blood thinning drug clopidogrel ranged in price between $10 and $59.95. A CVS in Bismarck, the state capital, quoted a price of $149.95 for the same dosage. "I get to set the prices here at my pharmacy," said Jenna Wahlstrom, a pharmacist at Larsen Service Drug, which her grandfather founded in Watford City in 1952. "It's not a corporate decision." Like the big chains, Wahlstrom offers her customers a smartphone app and online refill ordering. Her pharmacy has transferred hundreds of prescriptions from retail chains for workers who have moved to the state, she said. Ahead of the vote, the state's top politicians are declining to take sides. Governor Jack Dalrymple, a Republican who took office in 2010, says he shops at locally owned Aerohead Plaza Drug while in Bismarck and believes it has been able to compete effectively with the nearby CVS. Yet in the 1990s, as a state legislator, Dalrymple voted to keep the pharmacy law intact. "I don't know," he now says, "if that was the right vote." Claim: Big pharmacies knock on door of oil-rich North Dakota.

A:
North Dakota's oil boom has fueled a construction bonanza for new supermarkets, restaurants and clothing stores. But try finding a Rite Aid, Walgreens or other national pharmacy chain in the state, the fastest-growing economy in the nation, and you'll be largely out of luck.
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