Heat a large skillet over medium heat. Add ground beef and diced onion. Cook for 6-8 minutes, breaking up the beef, until browned and softened. Add minced garlic and cook for 1-2 minutes.

Stir in tomato paste, salt, black pepper, and red pepper flakes (if using). Cook for 1-2 minutes to enhance flavor.

Pour in crushed tomatoes and beef broth. Stir to combine and bring to a simmer.

Add orzo to the skillet, reduce the heat to medium-low, and cover. Cook for 10-12 minutes, stirring occasionally, until the orzo is tender and most of the liquid is absorbed.

Stir in heavy cream and let simmer for 2-3 minutes until creamy. Adjust seasoning as needed.

Sprinkle grated Parmesan cheese over the dish and garnish with fresh basil. Serve warm.