Yes MS200 has a combination digital and analog out as 3.5mm toslink/ mini stereo. The 218 will be compatible with MQA with analog and digital out to feed your tube amp. Yes the 218 as mentioned above is not a pretty box to set on a table top but it is designed to be mounted to a rack shelf and its performance and versatility should far supass its appearance.

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#1 Trinnov Altitude 32-8-16, 271, 8000XE, 7200SEHC, 7200.2, Seaton F18, JL Fathom F113, Revel w990's, Kef R7, ATI 528 Amp, JVC RS4100K, SI screen. Roon Nucleus+, Eno AG, Eno M link, 218.
#2 Mark Levinson No5105, Ayre VX8 and CX8, Vandersteen Treo CT, Preamp varies.
#3 Meridian Ellipse