On this 14-day trip to Beijing, Hangzhou, and Anhui, I noticed that attractions now all require real-name reservations, but passport holders get special treatment—some attractions even offer half-price discounts—and the hotels we stayed at were all able to help with reservations and buying high-speed rail tickets.
Cash is also accepted in China now. When I went six years ago, things weren't as friendly for foreign tourists. People's manners have improved a lot too—I didn't see spitting everywhere. The only thing is that although the restrooms are clean, there's no toilet paper.
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The biggest impact of real-name bookings on trip planning is flexibility—it gets cumbersome when you need to change plans at the last minute or book on behalf of someone traveling with you. Sorting out each day's reservations in advance can save you a lot of time.