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The 20-year-old Alcaraz will need to beat Medvedev in his final group game on Friday.
The earlier Green Group clash was a non-event as Stefanos Tsitsipas retired injured against Holger Rune.
Rublev, ranked fifth in the world, began to despair after losing the first set and failed to put up much of a fight in the second.
Jannik Sinner made a dream start in front of his home crowd with a 6-4, 6-4 defeat of Stefanos Tsitsipas in their opening Green Group clash.
The champions have won 19 of the 20 races so far, including the last five in a row
Brazilian striker Diego Maurcio scored the winner.
On a nightmare afternoon for Mexican teammate Sergio Perez, who retired after colliding at the first corner with Ferrari's Charles Leclerc, the Dutch 26-year-old also equalled French great Alain Prost's haul of 51 career wins.
Unbeaten FC Goa remain top of the points table after their four matches.
On October 15, a grand reception will be accorded to 'Zhen Hua 15', owned by Shanghai Zhen Hua Heavy Industries Company Limited, a Chinese state-owned multinational engineering company.
Max Verstappen cruised to his 14th win of an outstanding season for Red Bull.