Boil a large pot of salted water and cook the elbow macaroni until al dente, about 7-9.
In a large skillet over medium heat, cook the chopped bacon until crispy, about 5-7.
In the same skillet, sauté ground beef, diced onion, and minced garlic until beef is browned and onion is translucent, about 5-7.
Stir in beef broth, heavy cream, diced tomatoes, Worcestershire sauce, Italian seasoning, and season with salt and pepper. Simmer to meld flavors.
Add cooked macaroni and half of the shredded cheddar cheese, stirring until well coated and cheese is melted.
Sprinkle remaining cheddar cheese and crispy bacon on top, cover, and cook for an additional 2-3 until cheese is melted.
Garnish with chopped green onions and serve.