Grow Your Firm

Gusto Next: How to Scale Your Business to 500 Employees

Gusto Editors  
Smiling boss welcoming new member of team

Original webinar date: October 22, 2021
This article is part of a series where we share the top insights from Gusto Next—the premiere conference for accounting professionals. Read the entire series and watch Gusto Next 2021.

A tremendous yet challenging situation for any business is when rapid, exponential growth occurs. Fortunately, Gusto has the answers companies need for scaling their onboarding, payroll, and benefits packages quickly. In this Gusto Next session, Lauren Burke, Sales Leader at Gusto, and Josh Albrechtsen, Co-founder, and President of Cortex Health, shared how one client scaled their business from 14 employees to 500 in a short period and how Gusto provided the tools they needed to get there. 

To learn more about the future of accounting and how to support your clients, be sure to read all of the entries in the Gusto Next article series. Also, for a high-level overview of the conference, read Gusto Next 2021 is a Wrap — Here’s What You Might Have Missed.

How to scale your business to 500: the story of Cortex Health

In 2015, Riley Adamson and Josh Albrechtsen founded Cortex Health, a post-acute treatment provider that handles follow-up care after patients leave the hospital. For the first few years, the business worked on a small scale, offering services to local customers near Salt Lake City, UT. During the COVID pandemic, Cortex realized its model could reach more people through remote care, which led to exponential growth for the business.

“At Cortex, we call ourselves a healthcare outcome company. What that means is we help healthcare providers achieve repeatable healthcare outcomes. Typically those can range from preventing readmissions all the way to retaining staff and improving employee relationships and engagement. COVID in hospital settings and nursing homes was not an easy experience for caregivers, and many nurses were not in a position to continue offering care on the floor.”

Josh Albrechtsen
Two male employees with tablet discussing business

Cortex opened the ability to help patients remotely with registered nurses who could not work with patients in person. In a matter of months, the staff at Cortex grew from the core group of 14 to over 500 employees. This boom in employment presented new challenges for the team:

“The growth curve that we experienced in hiring 500 employees over the course of about six months was very challenging. Early on, the challenges we encountered were around recruiting and vetting our staff, but what quickly became apparent were compliance landmines and requirements we didn’t understand because we were willing to hire nurses across the United States.”

Josh Albrechtsen

Even though remaining compliant for employment and tax purposes proved to be difficult, Cortex could handle the rapid influx of employees because of the assistance they received from Gusto:

“As we started adding more and more nurses as employees, Gusto started recommending things like, ‘Hey, are you set up for taxes correctly?’ and, ‘Hey, have you done these ten things that you need to do to pay people in the state of New York.’ I loved [Gusto’s] dashboard because it relieved so much anxiety and stress. All of a sudden, we knew [Gusto] had all of the answers on how to set up in what became 44 states.”

Josh Albrechtsen

As Cortex grew, Gusto’s support expanded from a convenient payroll service for their 14 initial employees into a remote HR tool that gave Josh and Riley the confidence to provide benefits to all 500+ employees. With benefits packages, Gusto Wallet, and employee engagement surveys, Cortex provided the support its employees needed.

“All of our benefits are administered through Gusto. Gusto became the system of record for how we hire and onboard people, and it also became the mechanism that we use to get feedback from our team. … Gusto was very much a partner in the growth process for us. We needed help from them almost every day, and they grew with us by rolling out the features and benefits we needed from them. … Pre-COVID, I looked at Gusto as a payroll system. I now look at Gusto as our outsourced HR partner.”

Josh Albrechtsen

Gusto has the resources to provide efficient onboarding services, convenient payroll options, and HR tools to help companies grow from small to medium-sized organizations. The best part is that Gusto’s artificially intelligent software scales with the business and provides the right amount of service for clients according to size and necessity.

How Cortex Health continues to have excellent talent retention

For many companies, hiring and keeping talent is a challenge. Employee retention is lower than it has been in decades, but Cortex Health can recruit talented employees and continues to grow despite the current talent shortage. Partnering with Gusto helped Cortex grow in three significant ways.

Promoted employee receive congratulations from company staff

The first way we were able to help Cortex was by giving them the ability to create a flexible workplace. Gusto’s onboarding solutions allowed Cortex’s employees to join the team from anywhere in the nation, which is especially important for mothers working from home. 

“A few things really stood out to me [about Cortex]. First is the number of women they were able to keep in the workforce. Amidst the pandemic, female work participation dropped to 57%, the lowest level since 1988, according to the National Women’s Law Center. Many women who have left the workforce needed flexibility and the ability to prioritize the safety of their families. … Cortex offered that.”

Lauren Burke

After providing a flexible work situation, Cortex improved its value as an employer by implementing employee engagement surveys. These surveys made his team feel understood and heard—while giving Cortex valuable insights into the need for benefits options for its staff. Gusto’s easy benefits program allowed Josh to retain his employees.

“Josh recognized that they needed to offer better benefits to employees, and he did that by using Gusto’s engagement surveys. Then he offered benefits that really mattered using Gusto’s suite of no cost, low cost, and premium benefits.”

Lauren Burke

Finally, Gusto’s steps to improve their recommendation engine paid off exponentially for Cortex. By making suitable suggestions for tax requirements, Gusto’s system supported Cortex’s growth into a medium-sized organization. Instead of working through a headache caused by different state tax regulations, Josh could focus on making Cortex a place where employees wanted to work.

“The investments Gusto is making in automation with our recommendation engine are paying off. Powered by artificial intelligence, [Gusto’s recommendation engine] gave him the peace of mind that he needed through the pandemic to scale his incredible mission-driven business that is improving healthcare outcomes across the United States.”

Lauren Burke

By providing an easy way to onboard, simplified benefits packages, and support from Gusto’s recommendation engine, Cortex Health held the tools they needed to recruit talented employees. Josh and his team continue to grow with Gusto today despite the most considerable hiring shortage the nation has seen. 

Gusto has the tools to help your firm and clients grow

If you or your clients need help hiring talent and scaling your businesses, Gusto has the answers for you. Our state-of-the-art, simplified payroll software and HR solutions are the resources you need to provide a great place for employees to work. 

“At Gusto, we know what it means to hold the customer at the core of everything we do. One of the most fulfilling parts of my job is learning the small business stories and being able to see a business grow and flourish first-hand. Over the last decade, Gusto has had customers start side passion projects and grow them to businesses supported by hundreds of incredible employees.”

Lauren Burke

People are the center of Gusto’s mission to help accounting firms and their clients grow. Our business solutions and People Advisory Program allow companies to flourish without losing sight of what matters most to a business—its team.

If you’re curious about the future of accounting, watch the entire Gusto Next 2021 presentation here. Additionally, the Gusto Next 2021 wrap article is a convenient guide for everything we covered in this year’s convention. You can also join our waitlist to be notified about next year’s Gusto Next, where we’ll offer more solutions that support your clients through effective payroll, benefits, and HR tools.

Updated: April 4, 2022

Gusto Editors
Gusto Editors

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