This is pure speculation on my part, but I’ve been trying to understand how Miami keeps winning NIL battles. After piecing together different public comments and financial data, it looks pretty clear that
UHealth is the financial engine behind the entire operation.
UHealth generates roughly
$3.3B a year, and more importantly, it runs a
large operating surplus every year. That’s extremely rare in the academic medical world.
A few numbers jumped out at me:
- 63% of the entire university’s operating revenue now comes from UHealth.
- Academics and athletics basically run at break-even.
- UHealth subsidizes everything else.
Radakovich and Echevarria don’t spell out the details publicly, but the structure looks obvious:
UHealth → University Budget → Athletics (facilities, salaries, retention, stability)
Its cashflow is the backbone of the entire NIL ecosystem.
Miami is one of the only ACC schools with:
- a giant medical system,
- a large private-university budget,
- and a board actually willing to leverage both to support football.
Clemson, FSU, UNC, etc. can’t do this.
Why UHealth Is So Profitable
Here’s the interesting part:
UHealth isn’t one of the largest hospital systems, but it’s one of the most profitable relative to its size.
Most academic medical centers run on thin 2–4% margins.
UHealth posts
mid–single-digit to low–double-digit operating surpluses, plus higher unrestricted cashflow because UM is private and far less bureaucratic.
The secret?
South Florida’s demographics.
UHealth’s patient base is:
- older,
- wealthier,
- heavily insured,
- growing fast,
- filled with NYC/Chicago/Latin America transplants,
- dominated by private-pay and Medicare Advantage.
This is
exactly the population hospital systems want.
The margins per patient are dramatically higher than markets like Detroit, Pittsburgh, or Cleveland.
On top of that, Miami’s hospital market is unusually fragmented and weaker compared to big medical cities.
None of them have the academic brand, elite specialists, or research footprint UHealth now does. Miami saw the gap and moved fast.
Because UHealth is so profitable and covers so much of the university’s operations,
donors don’t have to be tapped for facilities, scholarships, or basic athletics infrastructure.
For context, UM received about
$1.02B in total contributions across the entire university in FY 2024 — academics, med school, athletics, everything.
UHealth’s profitability lets the university pay its own bills.
How This Ties Back to Football
Because UHealth is such a cash machine — and because leadership knows how to leverage it — Miami
doesn’t need donors for:
- buildings
- coaching salaries
- staff budgets
- operations
- recruiting infrastructure
All of that is handled by the university.
Which frees donors to focus on the only thing that actually wins in 2024:
NIL.
Miami might be the only school where:
- the university funds the infrastructure,
- donors fund the roster,
- the president’s office, UHealth, and athletics are aligned,
- and the health system provides long-term financial stability.
No other ACC school can replicate this.
Honestly, most SEC schools can’t either.
That’s why Miami can operate with SEC-level resources while being a small private university.
