Sandrine Coulange leads the Strategic Health Programs at AXA Next, the innovation team in charge of new business models at AXA Group, a French multinational insurance firm that specializes in global insurance, investment management, and other financial services. The innovation team focuses primarily on Population Health Management and telemedicine. Coulange will start a new position in early December:Head of Business Development Health & Employee Benefits Strategy at AXA International & New Markets. She joined the AXA Group in 2012, where she has held several positions at international level, including health services development at AXA Assistance, where she implemented a connected monitoring program for chronic patients in partnership with European governments. Prior to AXA, she worked for five years as a strategy and management consultant in financial services. She holds a MSc in Physics from the engineering school SupOptique and an MBA from the Ecole Supérieure de Commerce Paris (ESCP-EAP). Coulange, a speaker at the November Women’s Forum in Paris, recently spoke to The Innovator about Axa’s transition from an insurer to a provider of healthcare services.
Q: What is AXA Next and how does it fit in with the AXA Group’s overall strategy?
SC: In January of this year AXA launched “AXA Next”, an entity dedicated to innovation which aims to introduce new services, speed up the pace of innovation and help us to become a true partner for customers. We realized as a group that we don’t have much contact with the customer other than when they pay a bill or we process a claim. We want to be closer to our customers, to leverage technologies in order to have more touch points, to provide prevention and health services and reach out to them in their everyday lives, not just when they have serious health issues but also to be there to answer very basic questions such as ‘I am pregnant is it ok for me to have an X-Ray?’ The rationale behind the creation of AXA Next was to create an entity focused on new business models beyond insurance . ” Our only job is to design new business and we have created an ecosysytem to enable us to have the most relevant approach for each business cases : build, buy, investor or parner. We have an annual investment capacity of €200 million.
Q: Can you give us some examples of new business models?
SC: Health care systems are very different. In some countries private insurers are covering all the costs and in others — like France — social security is covering a lot of things. In some countries, if you want to have an impact you need to work closely with public players. A couple of years ago we started this journey by partnering with public hospitals and the Ministries of Health in Belgium and in Portugal. We developed a disease management monitoring solution for COPD, Cardiac Failure and Diabetes patient in collaboration with a Canadian start-up to set up an app-enabled solution that used connected devices. Monitoring of vitals such as weight, temperature and blood pressure, was overseen by AXA Assistance doctors and nurses to detect warning signs. This system of monitoring reduced hospitalization by 50%. In that specific case, we had a ‘partner’ approach with a start-up with a global agreement to be able to deploy in any country. As far as the ‘build’ approach is concernd we have a start-up studio called Kamet. The studio creates startups from the processing of an idea to the solidification phase. Lots of the energy goes towards finding the right people, both internally and externally. Padoa is one example of a Kamet startup. It reinvents occupational health by offering new processes and tools to enhance efficiency and agility while enabling to develop a real prevention policy for employees. Another example is Qare, a virtual clinic launched in France that integrates a network of highly experienced general practioners and specialists that can deliver 24/7 medical care either on video or chat and refer the patient to a physical consultation if required.
AI and telemedicine are fields that we are really keen on investing in. In Europe, there are many digital players specialized in areas such as appointment booking, teleconsultation and marketplaces but we lack an end- to-end user experience. This type of integrated approach is already a reality in China. In Europe we have been struggling because of regulatory constraints, but digital players are starting to expand their value proposition. We see a potential role for AXA in bringing together all the pieces so that people seeking medical care can have one smooth journey. These new business models are part of AXA’s shift to being a service provider, to make money out of the services we provide to other players. We see it as the only way to change and have an impact on health care.
Q: Last July AXA announced that it would open its own medical centers in emerging markets. How does that fit into to the company’s overall strategy?
SC: Vertical integration is indeed part of our new business model strategy. We are launching our own medical centers, linked directly to our health insurance services. By combining, in one offer, services that are normally delivered by different providers, we aim to simplify the healthcare journey. For example in Africa, we have chosen not to have a bricks and mortar-type solution to build our network of clinics, but rather to use digital services and technologies that don’t even exist yet in Western markets, such as medication delivery to homes, teleconsultations, the concept of health coaches, and more
AXA’s target is to open up to 50 medical clinics which would serve as many as 1.5 million clients across emerging markets by 2023, starting with Mexico in Latin America and Egypt in Africa, to be followed by other key emerging markets.
Q: What about the U.S. market?
SC: When we first decided to enter the U.S. market in 2017 we needed to figure out how to have a presence without ourselves being an insurer. This led us to aquire Maestro Health, a Chicago based service platform for those employers who decide they can cover the health costs of employees without adopting a traditional company-wide insurance policy (self-insured companies). We help these companies to better manage their health and employee benefits programs through an engagement platform, administrative work and Care Management.. Existing services were designed for big corporates but more and more mid-sized companies are starting to be self-insured so we are targeting our offer to include them.
Q: What can insurance companies in the West learn from PingAn, one of China’s largest insurers, which decided to transform itself from a financial services company to a technology company with financial services licenses ?
SC: It is quite impressive how they really integrate the whole ecosystem from online to offline. They engage people with their PingAn Good Doctor app and once people are there allow them to buy wellness products, book an appointment, chat with a doctor, buy drugs, you can do everything. It is very powerful in terms of digital and physical integration because it brings together pharmacies, hospitals and the payment system. Ping An has invested a lot in technology for many years. I think it is important that insurers keep investing in technology.
Q: What are the pain points in working with startups?
SC: Big corporates have a very clear road map for what they want to develop, and spend some time to formalize it. Startups raise funds and develop things in a more opportunistic manner, for example when they have a client request. So that is the first conflict: when you ask what is their exact product roadmap they are often not able to be very specific. From the startup’s side corporate procedures can be annoying because validation can be very long but what we bring to the startup is market, legal and financial expertise to price and launch products and roll them out globally. And sometimes also we bring people who want to make things happen inside the corporate environment.When teams can work together and pool their expertise there is a kind of magic. That is why my approach is very people oriented. It works when people are passionate and mission-driven.
Q: What have you learned during your time heading your innovation team?
SC: Being an intrapreneur is not as hard as being an entrepreneur but it does require you to be resilient and agile in the way you think about business models. It can be frustrating because things take longer inside a big company but don’t underestimate how being part of a big corporate can be a strength and give you a lot of power.