In a large pot over a medium-high heat, add ground beef, onions, garlic, salt, pepper, worcestershire sauce, and ketchup. Break up the beef to incorporate the seasonings and cook until browned, about 6-7 minutes.
Pour in the beef broth and one cup of water and bring to a simmer.
Add the pasta and simmer for 20 minutes or until the pasta is cooked throughout and the broth has cooked down, stirring occasionally.
Pour in the milk and cheese. Stir until the cheese has melted.