Health care spending is projected to grow at a historically low 7.5 percent for 2013, according to a report from PricewaterhouseCoopers’ Health Research Institute.

It’s the fourth straight year of relatively flat growth compared to inflation. Historically, the medical cost growth has been in the double digits, but since 2009, growth has slowed considerably. That’s a reflection of the sluggish economy, increased focus on cost containment by the industry, lower use of services by cost-conscious patients and efforts by employers to hold down expenses, the report explains.

PricewaterhouseCoopers based its research on input from health plan actuaries, industry leaders, analyst reports and employer surveys. Though health care spending often bounces back up as the economy recovers, the report identifies structural changes that may temper that pattern. A fourth year of relatively low growth suggests that the gap between health care spending and overall inflation may be narrowing to a more sustainable level. “Slower growth in health care costs could be the new normal,” says Michael Thompson, a principal at PwC. “We’re seeing long-term trends that could keep cost increases in check.