Serious air pollution can result in adverse health effects and economic costs. In this study, PM${}_{\mathrm{2.5}}$ predictions, their related health effects, and the resulting economic costs for 2020 and 2021 were performed. A novel grey model optimized using optimization algorithms was established to predict PM${}_{\mathrm{2.5}}$ concentration, and PM${}_{\mathrm{2.5}}$-related health effects and economic costs were estimated using exposure–response functions, data regarding health effects, and environmental value assessment methods. The experimental results show that (1) PM${}_{\mathrm{2.5}}$ values of Beijing, Tianjin, and Shijiazhuang are predicted to decline in 2020 and 2021, showing a trend of improving air quality; (2) the estimates of outpatient services and diseases account for largest proportion of the total health effects; (3) the economic costs of deaths and acute bronchial issues account for most of the overall costs, which can be regarded as a major means of reducing of health-related economic costs; (4) compared with Tianjin and Shijiazhuang, Beijing is expected to suffer the biggest economic cost, approximately 6505.84 million yuan, accounting for approximately 0.17% of the GDP in 2020, and 5554.94 million yuan, accounting for about 0.13% of the GDP in 2021, at the $C_0=10\mathrm{\mu }$g/m³ level, and is expected to suffer the lowest economic cost with approximately 0 yuan in 2020 and 2021 at the $C_0=35\mathrm{\mu }$g/m³ level. Overall, the findings provide a scientific basis for implementing air quality standards based on their expected health benefits and provide a reference for managing environmental air quality and implementing air quality health warnings and prevention measures.