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National spending for hospital care grew just 1.9% over the 12 months that ended in September, the lowest rate since September 2011, according to the latest from Altarum Institute's Center for Sustainable Health Spending. The report also notes a low rate of hospital employment growth for 2017. “Both of these trends may reflect the continuing shift in the delivery of care from inpatient to outpatient settings and in hospitals’ ongoing efforts to control costs,” the report said. National health spending growth was 4.3% for the second quarter of 2017, driven by the lower growth in hospital spending. In addition, health care approached a historic low, rising at a 1.1% annual growth rate compared to a year earlier, its lowest growth since the all-time low of 0.9% in December 2015. Hospital price growth also remained low at 1.4% in September.