Heat a large skillet over medium-high heat. Add the ground beef and cook until browned, breaking it up into small pieces as it cooks.
Add the onion and garlic to the skillet and cook for an additional 2-3 minutes, or until the onion is soft and translucent.
Add the beef broth, diced tomatoes, ketchup, Worcestershire sauce, oregano, paprika, salt, and black pepper to the skillet. Stir to combine and bring to a simmer.
Add the elbow macaroni to the skillet and stir to combine. Cover the skillet and cook for 10-12 minutes, or until the macaroni is tender and the sauce has thickened.
Stir in the shredded cheddar cheese until it's melted and well combined.
(Optional) Pre-heat the oven to 425F and bake for 10-12 minutes until the top is crispy.