Heat a large skillet over medium-high heat. Add onions and garlic and cook until fragrant. Add ground beef and cook until brown. Add salt, pepper, paprika and cayenne and stir to combine.
Add macaroni, cream, broth and tomato sauce and bring to a boil. Cook until pasta is tender, approximately 8 minutes, then reduce to a simmer. Add cheese and mix until melted. Remove from heat, top with parsley and serve immediately.