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Purpose – To develop a framework for studying financial incentive program implementation mechanisms, the means by which physician practices and physicians translate incentive program goals into their specific office setting. Understanding how new financial incentives fit with the structure of physician practices and individual providers’ work may shed some insight on the variable effects of physician incentives documented in numerous reviews and meta-analyses.

Design/Methodology/Approach – Reviewing select articles on pay-for-performance evaluations to identify and characterize the presence of implementation mechanisms for designing, communicating, implementing, and maintaining financial incentive programs as well as recognizing participants’ success and effects on patient care.

Findings – Although uncommonly included in evaluations, evidence from 26 articles reveals financial incentive program sponsors and participants utilized a variety of strategies to facilitate communication about program goals and intentions, to provide feedback about participants’ progress, and to assist practices in providing recommended services. Despite diversity in programs’ geographic locations, clinical targets, scope, and market context, sponsors and participants deployed common strategies. While these methods largely pertained to communication between program sponsors and participants and the provision of information about performance through reports and registries, they also included other activities such as efforts to engage patients and ways to change staff roles.

Limitations – This review covers a limited body of research to develop a conceptual framework for future research; it did not exhaustively search for new articles and cannot definitively link particular implementation mechanisms to outcomes.

Practical Implications – Our results underscore the effects implementation mechanisms may have on how practices incorporate new programs into existing systems of care which implicates both the potential rewards from small changes as well as the resources which may be required to obtain buy-in and support.

Originality/Value – We identify gaps in previous research regarding actual changes occurring in physician practices in response to physician incentive programs. We offer suggestions for future evaluation by proposing a framework for understanding implementation. Our model will assist future scholars in translating site-specific experiences with incentive programs into more broadly relevant guidance for practices by facilitating comparisons across seemingly disparate programs.

This paper responds to the lack of visitor engagement in many culture-based World Heritage sites and conceptualises a “Cuteification-Value Nexus” for the discussion of the communication of heritage values through “cute” or aesthetically pleasing popular culture elements. It reflects on observations in Macao to argue for a greater engagement of culture-based World Heritage sites through a combination of popular culture inspired motifs and truthful heritage messages. Specifically, it identifies a form of “cuteified heritage” – a hyperreal cultural zone that happens away from the actual heritage sites, but which articulates the heritage significances of those sites. This draws on concepts on themed spaces and insights from postmodernistic hyperreality and tourism to examine how the “completely real” becomes identified with the “completely fake” in the staging, consumption and negotiation of experiences with World Heritage and their utility in the management of World Heritage tourism sites.