Add onions to a large saucepan with olive oil. Cook over low-medium heat for 1-2 minutes or until onions have become semi-translucent and fragrant.

Add ground beef and continue to cook over medium-high heat for 6-8 minutes or until the beef is fully browned. When done, drain beef over a bed of paper towels and return to the saucepan.

Stir in the tomato paste, Worcestershire sauce and seasonings. Cook for about 1 minute, stirring and mixing frequently.

Add in the elbow macaroni, beef broth and heavy whipping cream and bring heat to high. Stir frequently as the mixture comes to a light boil (adjust your heat if needed). When boiling, place a lid over the pot and cook for an additional 12-14 minutes, stirring occasionally.

During the last minute of cooking, top with cheese and stir until fully melted and combined into the dish.

Remove from heat and serve immediately. Add additional salt and pepper to taste as needed.