Pay-TV bills continue to climb upward — and channel lineups have ballooned to record highs — but U.S. cable and satellite subscribers still tune to the same relatively small number of networks they have for years.

American TV viewers now watch only 9% of the channels available to them, which is a six-year low, according to a new report from Nielsen.

The report highlights a growing concern for the pay-TV biz: Consumers are paying more for exactly the same content they received before. That consistent trend has led to perceptions that the value of cable, satellite and telco TV is waning, and with expanding Internet video options more Americans may be prompted to cut the cord.

In 2013, the average U.S. TV home in 2013 received 189 TV channels, up from 129 in 2008. But over that time period, consumers have consistently tuned in to an average of just 17-18 channels on a regular basis.

SEE ALSO: TV Subscriptions Down; Will Cord-Cutting Get Worse?

Last year the U.S. pay-TV segment registered the first-ever overall decline in subscriptions, according to research firm SNL Kagan. The aggregate 251,000 net loss among cable, satellite and telco TV providers was very small, representing just 0.02% of 110.2 million total subscribers at year-end, but if that trend accelerates it could fuel a vicious cycle for the industry.

Cable programmers and pay-TV operators have responded by trying to quickly move to adopt “TV Everywhere.” The hypothesis is that the ability to access, say, HBO or ESPN on multiple devices will enhance the value of the traditional pay-TV bundle in consumers’ minds.

But according to industry execs, the TV Everywhere vision has not been fully realized. At the 2014 Cable Show last week, John Skipper, president of ESPN and co-chairman of Disney Media Networks, urged the biz to move faster to adopt multiscreen services to fight back against what he characterized as inferior digital services from Netflix and others.

“We have superior content,” he said. “We need superior delivery systems.” With services like Netflix touting their simplicity and content, “We are allowing them in some ways to set the tone of the conversation,” he said.

But it’s questionable whether more content on more screens will keep subscribers happy, amid the inexorable rise in programming costs — and given the fact that consumers are paying for numerous channels they never watch. Only 21% of pay-TV subscribers use TV Everywhere services from their provider at least once per month, according to new research from NPD Group.

So far, rising pay-TV prices haven’t seriously harmed the industry. But the “affordability problem is unsustainable,” said MoffettNathanson senior analyst Craig Moffett on a panel at the Cable Show last week. If cord-cutting takes hold, “the programmers’ view of a birthright to cost increases” will result in them raising prices even faster as the number of subscribers dwindles.

As Moffett put it: “The industry is in a speeding car headed to a cliff, and we’re pressing harder on the accelerator.”

Also at the Cable Show, Jerry Kent, CEO of midsize operator Suddenlink Communications, warned that the industry could hit a tipping point where customers abandon cable TV because of high prices. MSOs need “flexibility of working with programming to deliver lower-priced tiers” he said — otherwise, the government may step in to mandate a la carte pricing or the operators will have to jettison channels.