This study employs a coupling coordination degree model to analyze the spatial - temporal evolution of the coupling coordination level of the“Three Medical Systems”（medical care，basic medical insurance，and pharmaceutical industry）in the six central provinces of China. Building on this analysis，a grey forecasting model is applied to dynamically forecast the future development trends of the“Three Medical Systems”coupling coordination level in the central region from 2025 to 2030，providing a reference for advancing the orderly development of the healthcare systems in the six central provinces under the framework of integrated“Three Medical Systems”reform. The results indicate a steady increase in the coupling coordination level of the“Three Medical Systems”in the six central provinces from 2018 to 2022，though the overall level remained low with significant regional disparities. Predictions suggest that by 2030，all six provinces will reach a coordinated stage of development，with four provinces entering a high-level coupling phase. To achieve this， the central provinces should further strengthen primary medical care capacity，advance reforms in medical insurance payment methods，increase fiscal support，and promote the transformation and upgrading of the pharmaceutical industry.