This report summarizes the economic and fiscal impacts of the Greenville Hospital System (GHS) on Greenville County and the South Carolina Upstate (Greenville, Anderson, Laurens, Oconee, Pickens and Spartanburg counties). In 2000, GHS had operating revenues, net of adjustments for charity and negotiated charges, of $606 million and had 8,211 employees on the payroll for at least part of the year. GHS also generates significant economic impacts from purchases of supplies, equipment, and utilities; from construction of new facilities; from local spending by GHS employees; and from local expenditures by visitors to the GHS patients and by students at GHS training programs. Moreover, GHS payroll and expenditures result in local "multiplier" effects in the area. Finally, county and municipal governments, school districts and special purpose districts receive tax revenues from the direct and secondary impacts of GHS on the private sector.