CSG and hierarchical relationships still underpin, but a lot of effort was invested in BREP support over many years. There was already extensive support for polygonal BREP, but NURBS BREP was added to support seamless conversion of commercial CAD. BREP NURBS can be imported, ray traced, and facetized. BRL-CAD still needs direct surface editing, but you can mix implicit geometry with NURBS (e.g., subtract a hole) without issue. CSG entities can also be converted to BREP and work is ongoing to improve Boolean evaluation of BREP-on-BREP entities.

As for performance, implicit geometry with Booleans (i.e., "CSG") is typically an order of magnitude faster to evaluate (and an order of magnitude less memory than BREP/NURBS which is in turn an order of magnitude less memory than BREP/Poly). BREP/NURBS easily offer the most editing flexibility. CSG offers the most compression and programmability. BREP/Poly offers the most interop at the expense of representation fidelity, memory, and (sometimes) validity. All three can be "fast enough", but evaluation performance is still an important consideration on real/big models, e.g., fully detailed vehicles.

Note that generating an intermediate representation off CSG is not intrinsically necessary. When you have really fast+good solid ray tracing and analytic routines (and measuring tools) built around it, you don't need an intermediate rep. You just directly evaluate shotlines and get mathematically precise answers. That can be used for real-time geometry display, for measuring things, for identifying interferences, for computing properties, etc. That's BRL-CAD's primary niche specialty.